Efficacy of combination therapy with ezetimibe and statins versus a double dose of statin monotherapy in participants with hypercholesterolemia: a meta-analysis of literature
Yu M, Liang C, Kong Q, Wang Y, Li M
Lipids in health and disease · 54 citas
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación independiente
Según la declaración de financiación del texto completo.
Publicación
- Publicado
- 2020-01-04 · Lipids Health Dis · vol. 19 · número 1 · pág. 1
- Editorial
- BioMed Central
- Citado
- 106 citas · más que el 98% de estudios similares · 4.8× el promedio de su campo
- Impacto
- Entre el 10 % más citado de su campo
- Referencias
- 29 trabajos
- Acceso
- Acceso abierto (revista) · CC-BY
- Áreas de investigación
- Lipoproteins and Cardiovascular Health · Cholesterol and Lipid Metabolism · Cancer, Lipids, and Metabolism
- Palabras clave
- ezetimibe, statins, hypercholesterolemia, combination lipid-lowering therapy, LDL cholesterol, total cholesterol, HDL cholesterol, atorvastatin, simvastatin, rosuvastatin, lipid-lowering efficacy
- MeSH
- humans, hypercholesterolemia, cholesterol, drug combinations, hydroxymethylglutaryl-coa reductase inhibitors, aged, middle aged, female, male, cholesterol, ldl, cholesterol, hdl, randomized controlled trials as topic, ezetimibe
5 autores
- Min Yu🇨🇳The Affiliated Yongchuan Hospital of Chongqing Medical University
- Chunshui Liang🇨🇳Army Medical University; Xinqiao Hospital
- Qianran Kong🇨🇳The Affiliated Yongchuan Hospital of Chongqing Medical University
- Yihan Wang🇨🇳 · autor de correspondenciaThe Affiliated Yongchuan Hospital of Chongqing Medical University
- Minmin Li🇨🇳The Affiliated Yongchuan Hospital of Chongqing Medical University
Resumen
El texto original del estudio, en el idioma en que se publicó.
Background
The aim of this study was to compare and summarize the lipid-altering effects of combination therapy with ezetimibe and statins (E/S) and a double dose of statin (D/S) monotherapy on patients with hypercholesterolemia.
Methods
We conducted search on 2 medical databases, PubMed and EMBASE to identify all relevant studies. A meta-analysis was performed to clarify the efficacy in the two groups. Only double-blind Randomized controlled study (RCTs) of efficacy evaluation in the two groups with ezetimibe and statins and a double dose of statin in participants with hypercholesterolemia that examined low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and high-density lipoprotein (HDL) were included. Two reviewers extracted data from all primary studies independently. The primary data were the level of LDL-C, TC and HDL-C concentrations at the end point and are expressed as mean and standard deviation (SD).
Results
A total of 11 double-blind, active or placebo-controlled studies with 1926 hypercholesterolemia adults randomized to ezetimibe 10 mg added to ongoing statins (N = 994) or statin titration (doubling) (N = 932) were pooled for the global meta-analysis. The effect size between treatment groups within individual studies was assessed by weighted mean difference (MD) using a random- or fixed-effect model. The result showed that the participants in E/S group get obvious lower LDL-C [MD = -13.14 mg/dL, 95%CI (-16.83, -9.44), p = 0.00001] and TC concentration [MD = -23.79 mg/dL, 95%CI (-38.65, -8.93), p = 0.002] from baseline to follow-up, comparing to the D/S group. Besides, no significant between-group differences were observed for concentrations of HDL-C [MD = 0.46 mg/dL, 95%CI (- 1.14, 2.06), p = 0.57]. According to subgroup analysis, the combination of ezetimibe and atorvastatin (10 mg) [MD = -16.98 mg/dL, p < 0 .0001] or simvastatin (20 mg) [MD = -17.35 mg/dL, p < 0 .0001] showed stronger ability of reducing LDL-C than combination of ezetimibe and rosuvastatin (10 mg) [MD = -9.29 mg/dL, p = 0.05]. The efficacy of short-term (endpoint time between 6 to 16 week) and long-term (52 week) treatment in the LDL-C between two groups did not show significant differences. Besides, only participants from Asia treated with combination therapy were associated with a significant lower LDL-C concentration [MD = -14.7 mg/dL, p < 0 .0001].
Conclusions
The addition of ezetimibe to statin appears to be more effective on reducing LDL-C and TC concentrations than doubling the statin dose. Moreover, the ability to reduce cholesterol levels of combinations therapy with ezetimibe and different statins or to participants from different geographic location may vary, based on this meta-analysis, while more samples are needed to verify.
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