Efficacy of Ezetimibe/Simvastatin (10/10 mg) Versus High Dose Statin in Dyslipidemia Patients: A Meta-analysis of Randomized Controlled Trials

  • Gaoming YANG 1. Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China 2. Department of Neurology, Second Affiliated Hospital of Chengdu Medical College (China National Nuclear Corporation 416 Hospital), Cheng-du, 610000, China
  • Dengfeng HAN Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
  • Jianhua MA Department of Neurology, First Affiliated Hospital of Xinjiang Medical University, Urumqi, 830054, China
  • Xiaoning ZHANG Department of Neurology, Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University, Urumqi, 830054, China
Keywords: Ezetimibe; Statin; Cholesterol; Inflammation; Meta-analysis

Abstract

Abstract Background: The monotherapies of statin and ezetimibe had not successfully achieved their objectives in the management of lipid levels of dyslipidemia patients. We aimed to compare the effects of combined low-dose simvastatin and ezetimibe versus high-dose statin on the lipid-lowering treatment of dyslipidemia patients. Methods: We searched five databases published before May 2018, namely PubMed, Embase, Cochrane, Web of Science, and Clinicaltrials.gov. Completely published randomized controlled trials (RCTs) comparing the effect of high-dose statin (S) with ezetimibe/simvastatin (10/10 mg; E/S) on the management of dyslipidemia patients were included. Results: A total of ten RCTs met the inclusion criteria, including 1,624 patients (E/S:691, S:933). Six outcomes underwent pooled analysis, including weighted mean difference (WMD) from baseline in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), high sensitivity C-reactive protein (hs-CRP), triglyceride (TG), and non-high-density lipoprotein cholesterol (non-HDL-C). No significant gap was found between high-dose statin and ezetimibe/simvastatin (10/10 mg) in LDL-C (-1.55; 95% confidence interval [CI]:-4.42~1.31, P=0 .29), HDL-C (1.05; 95%CI:-0.21~2.3, P=0 .1), TG (4.03; 95%CI:-4.53~12.58, P=0 .36), and hs-CRP (0.14; 95%CI:-0.50~0.78, P=0.67). However, there was significant difference found between the two lipid-lowering treatments in TC (-0.45; 95%CI:-9.07~ -0.83, P=0.02) and non-HDL-C (-4.97; 95%CI -8.46~-1.49, P=0 .005). Conclusions: Ezetimibe co-administered with simvastatin (10 mg) and high-dose statin monotherapy may show similar effects in reducing LDL-C, TG, and hs-CRP levels and in increasing HDL-C levels. However, the results suggest that there was greater TC and non-HDL-C lowering through high-dose statin monotherapy as compared with ezetimibe/simvastatin co-administration.    

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Published
2019-07-18
How to Cite
1.
YANG G, HAN D, MA J, ZHANG X. Efficacy of Ezetimibe/Simvastatin (10/10 mg) Versus High Dose Statin in Dyslipidemia Patients: A Meta-analysis of Randomized Controlled Trials. Iran J Public Health. 48(8):1405-1417.
Section
Review Article(s)