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

摘要

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.