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Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis

Neither lowering of blood lipid levels nor treatment with statins definitively improves renal outcomes. Ezetimibe, a non-statin antilipidemic agent, is known to not only decrease blood lipid levels but also reduce inflammatory response and activate autophagy. We evaluated the effect of adding ezetim...

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Autores principales: Bae, Jaehyun, Hong, Namki, Lee, Byung-Wan, Kang, Eun Seok, Cha, Bong-Soo, Lee, Yong-ho
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141215/
https://www.ncbi.nlm.nih.gov/pubmed/32183405
http://dx.doi.org/10.3390/jcm9030798
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author Bae, Jaehyun
Hong, Namki
Lee, Byung-Wan
Kang, Eun Seok
Cha, Bong-Soo
Lee, Yong-ho
author_facet Bae, Jaehyun
Hong, Namki
Lee, Byung-Wan
Kang, Eun Seok
Cha, Bong-Soo
Lee, Yong-ho
author_sort Bae, Jaehyun
collection PubMed
description Neither lowering of blood lipid levels nor treatment with statins definitively improves renal outcomes. Ezetimibe, a non-statin antilipidemic agent, is known to not only decrease blood lipid levels but also reduce inflammatory response and activate autophagy. We evaluated the effect of adding ezetimibe to a statin on renal outcome compared with statin monotherapy by analyzing longitudinal data of 4537 patients treated with simvastatin 20 mg plus ezetimibe 10 mg (S + E) or simvastatin 20 mg alone (S) for more than 180 days. A propensity-score-based process was used to match baseline characteristics, medical history, and estimated glomerular filtration rate (eGFR) between S + E and S groups. Changes in serum creatinine and incidence of renal events, defined as doubling of serum creatinine to ≥1.5 mg/dL or occurrence of end-stage renal disease after the first day of treatment initiation, were compared between the groups. Among 3104 well-matched patients with a median follow-up of 4.2 years, the S + E group showed a significantly lower risk of renal events than the S group (hazard ratio 0.58; 95% CI 0.35-0.95, P = 0.032). In addition, the S + E group tended to preserve renal function compared with the S group throughout follow-up, as assessed by serum creatinine changes (P-values for time–group interactions <0.001). These data support the beneficial effects on renal function when combining ezetimibe with a statin.
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spelling pubmed-71412152020-04-10 Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis Bae, Jaehyun Hong, Namki Lee, Byung-Wan Kang, Eun Seok Cha, Bong-Soo Lee, Yong-ho J Clin Med Article Neither lowering of blood lipid levels nor treatment with statins definitively improves renal outcomes. Ezetimibe, a non-statin antilipidemic agent, is known to not only decrease blood lipid levels but also reduce inflammatory response and activate autophagy. We evaluated the effect of adding ezetimibe to a statin on renal outcome compared with statin monotherapy by analyzing longitudinal data of 4537 patients treated with simvastatin 20 mg plus ezetimibe 10 mg (S + E) or simvastatin 20 mg alone (S) for more than 180 days. A propensity-score-based process was used to match baseline characteristics, medical history, and estimated glomerular filtration rate (eGFR) between S + E and S groups. Changes in serum creatinine and incidence of renal events, defined as doubling of serum creatinine to ≥1.5 mg/dL or occurrence of end-stage renal disease after the first day of treatment initiation, were compared between the groups. Among 3104 well-matched patients with a median follow-up of 4.2 years, the S + E group showed a significantly lower risk of renal events than the S group (hazard ratio 0.58; 95% CI 0.35-0.95, P = 0.032). In addition, the S + E group tended to preserve renal function compared with the S group throughout follow-up, as assessed by serum creatinine changes (P-values for time–group interactions <0.001). These data support the beneficial effects on renal function when combining ezetimibe with a statin. MDPI 2020-03-15 /pmc/articles/PMC7141215/ /pubmed/32183405 http://dx.doi.org/10.3390/jcm9030798 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bae, Jaehyun
Hong, Namki
Lee, Byung-Wan
Kang, Eun Seok
Cha, Bong-Soo
Lee, Yong-ho
Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title_full Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title_fullStr Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title_full_unstemmed Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title_short Comparison of Renal Effects of Ezetimibe–Statin Combination versus Statin Monotherapy: A Propensity-Score-Matched Analysis
title_sort comparison of renal effects of ezetimibe–statin combination versus statin monotherapy: a propensity-score-matched analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7141215/
https://www.ncbi.nlm.nih.gov/pubmed/32183405
http://dx.doi.org/10.3390/jcm9030798
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