Cor Vasa 2014, 56(2):e128-e132 | DOI: 10.1016/j.crvasa.2014.01.006

Use of ezetimibe results in more patients reaching lipid targets without side effects

Michal Vrablík^d,*, Daniel Holmes^a,b, Barry Forer^c, Andrew Juren^a, Pawel Martinka^a, Jiri Frohlich^a,b

^a Healthy Heart Program, St. Paul's Hospital, Vancouver, Kanada

^b Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, Kanada

^c Measurement, Evaluation and Research Methodology Program, University of British Columbia, Vancouver, Kanada

^d III. interní klinika, 1. lékařská fakulta Univerzity Karlovy a Všeobecná fakultní nemocnice, Praha, Česká republika

Background: Ezetimibe's mechanism of action, complementary to that of statins, makes it a useful therapeutic option in patients intolerant of lipid-lowering drugs or in those not achieving target lipid levels.

Objectives: To evaluate the efficacy and safety of ezetimibe in a longterm follow-up of lipid clinic patients with emphasis on motivation for use and the impact on achievement of target lipid levels.

Methods: Two hundred and ninety-five clinic patients who were prescribed and took ezetimibe in the 13-month period following the drug's availability in Canada were identified from our database. Patients' history and laboratory data were collected before and at first visit after the ezetimibe therapy was started. Paired t-test and chi-square test were used for statistical comparisons of ezetimibe's effect on lipid parameters and the achievement of target lipid-levels respectively.

Results: Ezetimibe treatment increased significantly the proportion of patients achieving lipid targets (by 25% for LDL-C and by 21.7% for TC/HDL-C significantly by 18% (p < 0.001) and TC/HDL-C by 15% (p < 0.011). The effect of ezetimibe in combination with other lipid-lowering therapies was similar; LDL-C decreased by 22% (p < 0.001) and TC/HDL-C by 15.4% (p < 0.011). The same lipid-lowering effect was seen in patients with diabetes. In this subgroup, addition of ezetimibe to ongoing therapy led to three- and two-fold increase in LDL-C and TC/HDL-C target levels achievement, respectively. Only 7% of patients discontinued ezetimibe treatment due to side effects.

Conclusion: In patients referred to the lipid clinic (typically because of side effects or failure to reach targets on other lipid-lowering therapy) treatment with ezetimibe significantly increased proportion of those achieving their target lipid levels. This was not accompanied by significant side effects.

Keywords: Diabetes; Ezetimibe; Lipid targets; Monotherapy

Received: December 1, 2013; Revised: January 23, 2014; Accepted: January 28, 2014; Published: April 1, 2014  Show citation