Meta-analysis of the cholesterol-lowering effect of ezetimibe added to ongoing statin therapy
Mikhailidis DP, Sibbring GC, Ballantyne CM, Davies GM, Catapano AL
Current medical research and opinion · 116 citas
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2007-07-19 · Curr Med Res Opin · vol. 23 · número 8 · págs. 2009–2026
- Editorial
- Taylor & Francis
- Citado
- 146 citas · más que el 91% de estudios similares · 2.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 46 trabajos
- Acceso
- De pago
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Cancer, Lipids, and Metabolism
- Palabras clave
- ezetimibe, statin combination therapy, hypercholesterolemia, LDL cholesterol lowering, total cholesterol, HDL cholesterol, coronary artery disease, statin adverse effects, creatine kinase, liver enzymes, lipid-lowering therapy, statin intolerance, statin-induced myopathy, statin-induced rhabdomyolysis, statin-induced liver injury
- MeSH
- humans, hypercholesterolemia, azetidines, cholesterol, triglycerides, lipoproteins, placebos, anticholesteremic agents, hydroxymethylglutaryl-coa reductase inhibitors, randomized controlled trials as topic, ezetimibe
5 autores
- Dimitri P. Mikhailidis🇬🇧 · autor de correspondenciaThe Royal Free Hospital; University College London
- Gillian C. Sibbring
- Christie Mitchell Ballantyne🇺🇸Baylor College of Medicine
- G. M. Davies🇺🇸Merck & Co., Inc., Rahway, NJ, USA (United States)
- Alberico Luigi Catapano🇮🇹University of Milan
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
To review and analyse the evidence for the cholesterol-lowering effect of ezetimibe in adult patients with hypercholesterolaemia who are not at low-density lipoprotein cholesterol (LDL-C) goal on statin monotherapy.
Research design
Systematic review and meta-analysis.
Methods
MEDLINE and EMBASE were searched to identify ezetimibe randomised controlled trials (RCTs) published between January 1993 and December 2005. The meta-analysis combined data from RCTs, with a minimum treatment duration of 6 weeks, that compared treatment with ezetimibe 10 mg/day or placebo added to current statin therapy. The difference between treatments was analysed for four co-primary outcomes: mean percentage change from baseline in total cholesterol (TC), LDL-C, and high-density lipoprotein cholesterol (HDL-C), and number of patients achieving LDL-C treatment goal. Meta-analysis results are presented for a modified version of the inverse variance random effects model.
Results
Five RCTs involving a total of 5039 patients were included in the meta-analysis. The weighted mean difference (WMD) between treatments significantly favoured the ezetimibe/statin combination over placebo/statin for TC (-16.1% (-17.3, -14.8); p < 0.0001), LDL-C (-23.6% (-25.6, -21.7); p < 0.0001) and HDL-C (1.7% (0.9, 2.5); p < 0.0001). The relative risk of reaching the LDL-C treatment goal was significantly higher for patients on ezetimibe/statin relative to those on placebo/statin (3.4 (2.0, 5.6); p < 0.0001). In pre-defined sub-group analyses of studies in patients with coronary heart disease, the WMD between treatments remained significantly in favour of ezetimibe/statin (p < 0.0001) for TC and LDL-C but was no longer significant for HDL-C. Elevations in creatine kinase, alanine aminotransferase or aspartate aminotransferase that were considered as an adverse effect did not differ significantly between treatments.
Conclusions
The meta-analysis we performed included only five studies and was restricted to analysis of the changes in cholesterol levels relative to baseline. However, the results suggest that ezetimibe co-administered with ongoing statin therapy provides significant additional lipid-lowering in patients not at LDL-C goal on statin therapy alone, allowing more patients to reach their LDL-C goal.
Resumen vía Europe PMC. Los derechos de autor siguen siendo de los autores o la editorial.
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