Author/Authors :
YANG ، Gaoming - First Affiliated Hospital of Xinjiang Medical University , HAN ، Dengfeng - First Affiliated Hospital of Xinjiang Medical University , MA ، Jianhua - First Affiliated Hospital of Xinjiang Medical University , ZHANG ، Xiaoning - Xinjiang Medical University
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 out-comes underwent pooled analysis, including weighted mean difference (WMD) from baseline in total choles-terol (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). Conclusion: 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.
Keywords :
Ezetimibe , Statin , Cholesterol , Inflammation , Meta , analysis
