Effectiveness of fixed-dose ezetimibe+simvastatin in real-life hypercholesterolaemia treatment: a retrospective observational study in Taiwan

Q Medicine Clinical Lipidology Pub Date : 2017-01-01 DOI:10.1080/17584299.2017.1368913

Yi-Chung Shih, Huan Lin

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Abstract

ABSTRACT Background: Combining statins with ezetimibe synergistically enhances lipid lowering, thereby reducing the need to prescribe maximal statin doses to achieve low-density lipoprotein cholesterol (LDL-C) goals. Real-world data on concurrent ezetimibe + statin therapy in Asians are sparse. Therefore, we evaluated the effectiveness of a single combined tablet of ezetimibe + simvastatin 10.0 + 20.0 mg (EZE + SIM) in Taiwanese patients with hypercholesterolaemia. Methods: We analysed retrospective data from patients who received EZE + SIM at a community hospital in New Taipei City, Taiwan, took EZE + SIM continuously for ≥24 weeks, and had before and after lipid data. Outcomes including lipid lowering, LDL-C goal attainment and safety (non-lipid serum biochemistry), were compared between diabetic versus non-diabetic patients and subgroups prescribed different EZE + SIM doses. Results: Among 157 EZE + SIM users, more than half had diabetes (64.3%) and/or hypertension (52%) and 24.1% had coronary artery disease. A mean EZE + SIM dose of 6.5 + 13.0 (median 5.0 + 10.0) mg/day for a mean of 51.6 weeks, significantly reduced total cholesterol (−30.4%), LDL-C (−36.2%) and triglycerides (−14.5%); consequently, attainment rates of LDL-C ≤ 100 mg/dl and ≤70 mg/dl goals were significantly higher after EZE + SIM treatment. There were no clinically significant changes in biomarkers of hepatic or renal function. Consistent with other reports, we observed indications of greater lipid-lowering efficacy and LDL-C goal attainment among patients with diabetes versus those without, at equivalent EZE + SIM doses. Conclusions: Our findings affirm the lipid-lowering efficacy of single-tablet fixed-dose EZE + SIM in real-world Taiwanese-Chinese patients with hypercholesterolaemia, especially at the recommended dose. Trends towards greater efficacy in diabetic than non-diabetic patients suggest that EZE + SIM may be a rational choice for treating patients with hypercholesterolaemia and diabetes.

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固定剂量依折替贝+辛伐他汀治疗高胆固醇血症的有效性:台湾回顾性观察研究

背景:他汀类药物联合依zetimibe可协同增强降脂作用，从而减少了为达到低密度脂蛋白胆固醇(LDL-C)目标而开出最大剂量他汀类药物的需要。关于依折麦布+他汀类药物同时治疗亚洲患者的实际数据很少。因此，我们评估了依泽替米贝+辛伐他汀10.0 + 20.0 mg (EZE + SIM)单片联合治疗台湾高胆固醇血症患者的有效性。方法:回顾性分析台湾新北市某社区医院接受EZE + SIM治疗、连续服用EZE + SIM≥24周、前后血脂数据的患者资料。结果包括血脂降低，LDL-C目标达到和安全性(非脂类血清生化)，比较糖尿病患者与非糖尿病患者和亚组之间使用不同剂量的EZE + SIM。结果:157名EZE + SIM用户中，超过一半患有糖尿病(64.3%)和/或高血压(52%)，24.1%患有冠状动脉疾病。平均EZE + SIM剂量为6.5 + 13.0(中位数为5.0 + 10.0)mg/天，平均51.6周，显著降低总胆固醇(- 30.4%)、LDL-C(- 36.2%)和甘油三酯(- 14.5%);因此，EZE + SIM治疗后LDL-C≤100 mg/dl和≤70 mg/dl目标的达标率显著提高。肝脏或肾脏功能的生物标志物没有明显的临床变化。与其他报告一致，我们观察到在同等EZE + SIM剂量下，糖尿病患者与非糖尿病患者相比具有更高的降脂效果和LDL-C目标。结论:我们的研究结果证实了单片固定剂量EZE + SIM对现实生活中台湾-中国大陆高胆固醇血症患者的降脂效果，特别是在推荐剂量下。糖尿病患者比非糖尿病患者更有效的趋势表明，EZE + SIM可能是治疗高胆固醇血症和糖尿病患者的合理选择。

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来源期刊

Clinical Lipidology 生物-生化与分子生物学

CiteScore

0.44

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Lipidology is published to support the diverse array of medical professionals who work to reduce the incidence of morbidity and mortality from dyslipidemia and associated disorders of lipid metabolism. The Journal''s readership encompasses a broad cross-section of the medical community, including cardiologists, endocrinologists, and primary care physicians, as well as those involved in the treatment of such disorders as diabetes, hypertension, and obesity. The Journal also addresses allied health professionals who treat the patient base described above, such as pharmacists, nurse practitioners and dietitians. Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.