Total and low-density lipoprotein cholesterol responses to ezetimibe in clinical practice

Clinical trials have shown that ezetimibe significantly improves lipid profiles when used as monotherapy or in combination with a statin or fibrate. To assess its effect in clinical practice, a retrospective audit of changes in total cholesterol (TC) and low-density lipoprotein cholesterol (LDLC) was conducted in 180 hospital outpatients (mean age 57 years, 58% male) who received ezetimibe for at least 4 weeks. When added to existing therapy, (n = 164) mean reductions in TC and LDLC were 19 and 26%, respectively, larger falls occurring in those already on a statin than when on a fibrate or when used as monotherapy. Bigger mean reductions in TC and LDLC (25 and 36%, respectively) were seen in patients already on a statin and fibrate where ezetimibe replaced the fibrate (n = 16). There were a large range of TC and LDLC responses in each treatment group which are likely to relate, at least in part, to individual variability in cholesterol absorption. As expected from the improvement in TC and LDLC, more patients achieved recognised cholesterol targets after ezetimibe use. The response to ezetimibe in routine practice appears to be consistent with that seen in clinical trials.