Efficacy of Ezetimibe/Simvastatin (10/10 mg) versus High Dose Statin in Dyslipidemia Patients: A Meta-Analysis of Randomized Controlled Trials

BACKGROUND: The monotherapies of statin and ezetimibe had not successfully achieved their objectives in the management of lipid levels of dyslipidemia patients. We aimed to compare the effects of combined low-dose simvastatin and ezetimibe versus high-dose statin on the lipid-lowering treatment of d...

Descripción completa

Detalles Bibliográficos
Autores principales: YANG, Gaoming, HAN, Dengfeng, MA, Jianhua, ZHANG, Xiaoning
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Tehran University of Medical Sciences 2019
Materias:
Review Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7145912/
https://www.ncbi.nlm.nih.gov/pubmed/32292723
Descripción
Sumario:BACKGROUND: The monotherapies of statin and ezetimibe had not successfully achieved their objectives in the management of lipid levels of dyslipidemia patients. We aimed to compare the effects of combined low-dose simvastatin and ezetimibe versus high-dose statin on the lipid-lowering treatment of dyslipidemia patients. METHODS: We searched five databases published before May 2018, namely PubMed, EMBASE, Cochrane, Web of Science, and Clinicaltrials.gov. Completely published randomized controlled trials (RCTs) comparing the effect of high-dose statin (S) with ezetimibe/simvastatin (10/10 mg; E/S) on the management of dyslipidemia patients were included. RESULTS: A total of ten RCTs met the inclusion criteria, including 1,624 patients (E/S:691, S:933). Six outcomes underwent pooled analysis, including weighted mean difference (WMD) from baseline in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high sensitivity C-reactive protein (hs-CRP), triglyceride (TG), and non-high-density lipoprotein cholesterol (non-HDL-C). No significant gap was found between high-dose statin and ezetimibe/simvastatin (10/10 mg) in LDL-C (−1.55; 95% confidence interval [CI]: −4.42∼1.31, P=0 .29), HDL-C (1.05; 95%CI: −0.21∼2.3, P=0 .1), TG (4.03; 95%CI: −4.53∼12.58, P=0.36), and hs-CRP (0.14; 95%CI: −0.50∼0.78, P=0.67). However, there was significant difference found between the two lipid-lowering treatments in TC (−0.45; 95%CI: −9.07∼−0.83, P=0.02) and non-HDL-C (−4.97; 95%CI −8.46∼−1.49, P=0.005). CONCLUSION: Ezetimibe co-administered with simvastatin (10 mg) and high-dose statin monotherapy may show similar effects in reducing LDL-C, TG, and hs-CRP levels and in increasing HDL-C levels. However, the results suggest that there was greater TC and non-HDL-C lowering through high-dose statin monotherapy as compared with ezetimibe/simvastatin co-administration.

Ejemplares similares