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Comparative efficacy of ezetimibe/simvastatin, rosuvastatin, and atorvastatin in uncontrolled hyperlipidemia patients

Amy Furman1, Joy L Meier, Robert A Malmstrom

  • 1Department of Veterans Affairs, Northern California Health Care System, Mather, CA 95655, USA.

The American Journal of Managed Care
|August 20, 2011
PubMed

Insights

Ezetimibe/simvastatin demonstrated superior low-density lipoprotein (LDL) reduction compared to rosuvastatin or atorvastatin in high-risk patients. Further research is needed to determine the clinical impact of these findings.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Practice

Background:

  • Dyslipidemia treatment in high-risk patients aims for low-density lipoprotein (LDL) cholesterol <100 mg/dL.
  • Efficacy of potent lipid-lowering regimens in patients not achieving goals on generic therapy requires further characterization.

Purpose of the Study:

  • To determine the LDL-lowering efficacy of higher-potency statin strategies (ezetimibe/simvastatin, rosuvastatin, atorvastatin) in high-risk patients switched from simvastatin.
  • To evaluate patient adherence, effects on other lipid parameters, and adverse events.

Main Methods:

  • Retrospective analysis of Veterans Affairs Health Care System data (3-year period).
  • Lipid data assessed pre- and post-conversion from simvastatin (2-6 months).
  • Medication refill data used to determine therapy adherence.

Main Results:

  • Ezetimibe/simvastatin achieved significantly greater LDL reduction (37 mg/dL) versus rosuvastatin (25 mg/dL) or atorvastatin (26 mg/dL) (P <0.05).
  • Adherence to therapy was 51%.
  • All interventions lowered total cholesterol, HDL, and triglycerides compared to simvastatin; no significant difference in adverse events between groups.

Conclusions:

  • Ezetimibe/simvastatin demonstrated superior LDL reduction compared to rosuvastatin or atorvastatin at the doses used.
  • The clinical significance of these observed LDL reduction differences remains undetermined.
Abstract

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