Adding ezetimibe to a medium-intensity statin regimen enhance tolerance while keeping preventative benefit
Reviewed Dat Tien Nguyen, B.A, ScM. Posted on August 15th, 2022
Rosuvastatin is frequently prescribed at high dosage to effectively lower a patient’s blood cholesterol level. However, due to the side effect, many patients are very uncomfortable with taking the medication; as a result, this lowers compliance and reduces overall efficacy. Ezetimibe is another cholesterol lowering agent that decreases the absorption of cholesterol by the small intestine. A recent study found that a combination of ezetimibe and mid-intensity rosuvastatin is as effective as preventing cardiovascular events but with a lower rate of discontinuation.
The trial randomly assigned half of the 3,780 participants to take a monotherapy of high-intensity rosuvastatin (20 mg), and the other were assigned to take a combination therapy of medium intensity rosuvastatin (10 mg) and ezetimibe (10 mg). After 3 years of follow-up, those who were in the combination therapy group experience cardiovascular events at a similar rate to those in the monotherapy group. In terms of the effect on cholesterol concentration, 72% of those who take ezetimibe with rosuvastatin manage to lower their LDL-C to below 70 mg/dL. Only 58% of those who took only rosuvastatin were able to reach the desirable LDL-C concentration.
Both groups experience myopathy and myonecrosis at the same level. However, those in the monotherapy group had reported more myalgia and dizziness. Due to these side effects, 8.2% of those in the monotherapy group discontinue their treatment; whereas, only 4.8% in the combined therapy stop their treatment. Thus, clinical guidelines should be changed appropriately in order to improve the regimen efficacy.
The trial randomly assigned half of the 3,780 participants to take a monotherapy of high-intensity rosuvastatin (20 mg), and the other were assigned to take a combination therapy of medium intensity rosuvastatin (10 mg) and ezetimibe (10 mg). After 3 years of follow-up, those who were in the combination therapy group experience cardiovascular events at a similar rate to those in the monotherapy group. In terms of the effect on cholesterol concentration, 72% of those who take ezetimibe with rosuvastatin manage to lower their LDL-C to below 70 mg/dL. Only 58% of those who took only rosuvastatin were able to reach the desirable LDL-C concentration.
Both groups experience myopathy and myonecrosis at the same level. However, those in the monotherapy group had reported more myalgia and dizziness. Due to these side effects, 8.2% of those in the monotherapy group discontinue their treatment; whereas, only 4.8% in the combined therapy stop their treatment. Thus, clinical guidelines should be changed appropriately in order to improve the regimen efficacy.