Moderate-Intensity Rosuvastatin/Ezetimibe Combination versus Quadruple-Dose Rosuvastatin Monotherapy: A Meta-Analysis...

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Clinical Trials

Background:

• Low-density lipoprotein cholesterol (LDL-C) reduction is crucial for cardiovascular disease prevention.
• Comparing the efficacy and safety of combination therapy versus high-dose monotherapy is essential for optimizing lipid management.
• Limited studies exist on equivalent LDL-C reduction and safety profiles between rosuvastatin/ezetimibe combination and high-dose rosuvastatin.

Approach:

• A systematic literature search was performed across major databases (PubMed, EMBASE, Cochrane, Web of Sciences, SCOPUS) up to December 2021.
• Included randomized controlled trials comparing 5 mg rosuvastatin/10 mg ezetimibe to 20 mg rosuvastatin.
• A random-effects meta-analysis assessed lipid-modifying efficacy (LDL-C, total cholesterol, triglycerides, HDL-C) and composite adverse events.

Key Points:

• No significant difference in LDL-C reduction between 5 mg rosuvastatin/10 mg ezetimibe and 20 mg rosuvastatin (SMD 0.08, p=0.35).
• Composite adverse event rates were comparable between the two treatment groups (OR 0.50, p=0.27).
• The combination therapy showed a statistically significant greater reduction in total cholesterol (SMD 0.22, p=0.02).

Conclusions:

• 5 mg rosuvastatin/10 mg ezetimibe demonstrates comparable lipid-modifying efficacy to 20 mg rosuvastatin.
• The combination therapy exhibits similar tolerability and safety profiles to high-dose rosuvastatin monotherapy.
• This finding supports the use of rosuvastatin/ezetimibe combination for achieving LDL-C goals with comparable safety.