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Consistency of effect of ezetimibe/simvastatin compared with intensified lipid-lowering treatment strategies in obese and non-obese diabetic subjects.

Rosen JB, Jimenez JG, Pirags V, Vides H, Massaad R, Hanson ME, Brudi P, Triscari J - Lipids Health Dis (2013)

Bottom Line: In obese subjects (n = 466), percent changes in LDL-C and most other lipids were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin.In non-obese subjects (n = 342), percent changes in LDL-C, total cholesterol, non-HDL-C, Apo B and Apo A-I were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin; and treatment with ezetimibe/simvastatin resulted in greater changes in triglycerides vs rosuvastatin and HDL-C vs doubling the baseline statin dose.Regardless of baseline obesity status, switching to ezetimibe/simvastatin was more effective at reducing LDL-C, total cholesterol, non-HDL-C, and Apo B vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Purpose: This post hoc analysis assessed switching to ezetimibe/simvastatin 10/20 mg vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg in subgroups of obese (BMI ≥30 kg/m2) and non-obese (BMI <30 kg/m2) diabetic subjects.

Methods: This was a randomized, double-blind, 12-week study of adults 18-79 years with cardiovascular disease with low-density lipoprotein cholesterol (LDL-C) ≥70 and ≤160 mg/dl. Percent change in LDL-C and other lipids was estimated.

Results: In obese subjects (n = 466), percent changes in LDL-C and most other lipids were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin. In non-obese subjects (n = 342), percent changes in LDL-C, total cholesterol, non-HDL-C, Apo B and Apo A-I were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin; and treatment with ezetimibe/simvastatin resulted in greater changes in triglycerides vs rosuvastatin and HDL-C vs doubling the baseline statin dose. The safety profiles were generally similar.

Conclusions: Regardless of baseline obesity status, switching to ezetimibe/simvastatin was more effective at reducing LDL-C, total cholesterol, non-HDL-C, and Apo B vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg.

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Least squares mean percent change from baseline in lipids, lipoproteins and hs-CRP after 6 weeks of treatment. Bars represent standard error. (FAS population). a. Obese subjects. b. non-obese subjects.
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Figure 4: Least squares mean percent change from baseline in lipids, lipoproteins and hs-CRP after 6 weeks of treatment. Bars represent standard error. (FAS population). a. Obese subjects. b. non-obese subjects.

Mentions: In both obese and non-obese subjects, treatment with ezetimibe/simvastatin 10/20 mg resulted in numerically greater changes in total cholesterol, non-HDL-C, and Apo B compared with doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or vs switching to rosuvastatin 10 mg (Table 2 and Figures 4a and 4b). However, changes in HDL-C and Apo A-I appeared to be similar between treatments in obese subjects (Figure 4a). In non-obese subjects (Figure 4b) changes in triglycerides were numerically greater in the ezetimibe/simvastatin 10/20 treatment group compared with the rosuvastatin 10 mg group, while the subjects whose baseline statin dose was doubled showed similar decreases to subjects treated with ezetimibe/simvastatin 10/20 mg. In non-obese subjects, changes in HDL-C were similar between treatment groups, and increases in Apo A-I were greater in the ezetimibe/simvastatin 10/20 mg vs the doubling the baseline statin dose group (Figure 4b). In both obese and non-obese subjects changes in hs-CRP were numerically greater with rosuvastatin 10 mg vs ezetimibe/simvastatin 10/20 mg (Figures 4a and 4b). In both obese and non-obese subjects, ezetimibe/simvastatin 10/20 mg was more effective at improving lipid ratios compared with doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg, although the changes were similar to those of rosuvastatin 10 mg-treated subjects in both obese and non-obese subjects (Figures 5a and 5b).


Consistency of effect of ezetimibe/simvastatin compared with intensified lipid-lowering treatment strategies in obese and non-obese diabetic subjects.

Rosen JB, Jimenez JG, Pirags V, Vides H, Massaad R, Hanson ME, Brudi P, Triscari J - Lipids Health Dis (2013)

Least squares mean percent change from baseline in lipids, lipoproteins and hs-CRP after 6 weeks of treatment. Bars represent standard error. (FAS population). a. Obese subjects. b. non-obese subjects.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3722050&req=5

Figure 4: Least squares mean percent change from baseline in lipids, lipoproteins and hs-CRP after 6 weeks of treatment. Bars represent standard error. (FAS population). a. Obese subjects. b. non-obese subjects.
Mentions: In both obese and non-obese subjects, treatment with ezetimibe/simvastatin 10/20 mg resulted in numerically greater changes in total cholesterol, non-HDL-C, and Apo B compared with doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or vs switching to rosuvastatin 10 mg (Table 2 and Figures 4a and 4b). However, changes in HDL-C and Apo A-I appeared to be similar between treatments in obese subjects (Figure 4a). In non-obese subjects (Figure 4b) changes in triglycerides were numerically greater in the ezetimibe/simvastatin 10/20 treatment group compared with the rosuvastatin 10 mg group, while the subjects whose baseline statin dose was doubled showed similar decreases to subjects treated with ezetimibe/simvastatin 10/20 mg. In non-obese subjects, changes in HDL-C were similar between treatment groups, and increases in Apo A-I were greater in the ezetimibe/simvastatin 10/20 mg vs the doubling the baseline statin dose group (Figure 4b). In both obese and non-obese subjects changes in hs-CRP were numerically greater with rosuvastatin 10 mg vs ezetimibe/simvastatin 10/20 mg (Figures 4a and 4b). In both obese and non-obese subjects, ezetimibe/simvastatin 10/20 mg was more effective at improving lipid ratios compared with doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg, although the changes were similar to those of rosuvastatin 10 mg-treated subjects in both obese and non-obese subjects (Figures 5a and 5b).

Bottom Line: In obese subjects (n = 466), percent changes in LDL-C and most other lipids were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin.In non-obese subjects (n = 342), percent changes in LDL-C, total cholesterol, non-HDL-C, Apo B and Apo A-I were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin; and treatment with ezetimibe/simvastatin resulted in greater changes in triglycerides vs rosuvastatin and HDL-C vs doubling the baseline statin dose.Regardless of baseline obesity status, switching to ezetimibe/simvastatin was more effective at reducing LDL-C, total cholesterol, non-HDL-C, and Apo B vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Purpose: This post hoc analysis assessed switching to ezetimibe/simvastatin 10/20 mg vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg in subgroups of obese (BMI ≥30 kg/m2) and non-obese (BMI <30 kg/m2) diabetic subjects.

Methods: This was a randomized, double-blind, 12-week study of adults 18-79 years with cardiovascular disease with low-density lipoprotein cholesterol (LDL-C) ≥70 and ≤160 mg/dl. Percent change in LDL-C and other lipids was estimated.

Results: In obese subjects (n = 466), percent changes in LDL-C and most other lipids were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin. In non-obese subjects (n = 342), percent changes in LDL-C, total cholesterol, non-HDL-C, Apo B and Apo A-I were greater with ezetimibe/simvastatin vs doubling the baseline statin dose or switching to rosuvastatin; and treatment with ezetimibe/simvastatin resulted in greater changes in triglycerides vs rosuvastatin and HDL-C vs doubling the baseline statin dose. The safety profiles were generally similar.

Conclusions: Regardless of baseline obesity status, switching to ezetimibe/simvastatin was more effective at reducing LDL-C, total cholesterol, non-HDL-C, and Apo B vs doubling the baseline statin dose to simvastatin 40 mg or atorvastatin 20 mg or switching to rosuvastatin 10 mg.

Show MeSH
Related in: MedlinePlus