Colesevelam HCl and Ezetimibe Combination Therapy Provides Effective Lipid-Lowering in Difficult-to-Treat Patients with Hypercholesterolemia

Zema, Michael J.

doi:10.1097/01.mjt.0000155109.69831.a3

Cited by 53 publications

(30 citation statements)

References 10 publications

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“…7 A combination of ezetimibe/ colesevelam has reduced LDL-C levels by 42% with no reports of discontinuation due to adverse events. 45 In the Lipid Research Clinics Trial, cholestyramine decreased cardiovascular disease events by 25%. Niacin monotherapy reduced nonfatal myocardial infarctions by 27% and cerebrovascular events by 26% at a six-year follow-up as well as resulted in an 11% relative reduction in all-cause mortality at 15 years compared to a placebo in one study.…”

Section: Management Of Dyslipidaemiamentioning

confidence: 99%

Statin-Associated Muscle Adverse Events: Update for clinicians

Al-Mohaissen¹,

Ignaszewski²,

Fröhlich³

et al. 2016

SQUMJ

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Statins are potent medications which reduce low-density lipoprotein cholesterol (LDL-C) levels. Their efficacy in cardiovascular risk reduction is well established and indications for their use are expanding. While statins are generally well tolerated and safe, adverse events are relatively common, particularly statinassociated muscle adverse events (SaMAEs), which are the most frequently encountered type of adverse event. Recent guidelines and guideline updates on SaMAEs and statin intolerance have included revised definitions of SaMAEs, incorporating new evidence on their pathogenesis and management. As SaMAEs emerge as a therapeutic challenge, it is important for physicians to be aware of updates on management strategies to ensure better patient outcomes. The majority of patients who are considered statin-intolerant can nevertheless tolerate some forms of statin therapy and successfully achieve optimal LDL-C levels. This review article discusses the recent classification of SaMAEs with emphasis on pathogenesis and management strategies.

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Section: Management Of Dyslipidaemiamentioning

confidence: 99%

Statin-Associated Muscle Adverse Events: Update for clinicians

Al-Mohaissen¹,

Ignaszewski²,

Fröhlich³

et al. 2016

SQUMJ

View full text Add to dashboard Cite

show abstract

“…It can be administered in combination with other lipid medications in FH patients who do not tolerate statins. [34][35][36][37][38][39] Bile acid sequestrants (colesevelam, cholestyramine, colestipol) are anion-exchange compounds that prevent reabsorption of bile acids in the intestine. They have been shown to decrease LDL cholesterol concentrations by up to 20% 40 and can be added to statin therapy in FH patients requiring additional LDL cholesterol lowering.…”

Section: Drug Treatment Of Fhmentioning

confidence: 99%

Management of Familial Hypercholesterolemias in adult patients: Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia

Ito

McGowan

Moriarty

2011

Journal of Clinical Lipidology

130

101

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“…Zema, et al performed an open-label study, in which patients were initially on monotherapy with either colesevelam 3.75 g/day or ezetimibe 10 mg daily for 6 weeks. 45 A second drug was added to their regimen for another 6 weeks. Ezetimibe added on to colesevelam therapy produced a further reduction of 19% in LDL-c and 16% in non-HDL-c.…”

Section: Combination With Statinsmentioning

confidence: 99%

Current and Emerging Therapies in Hypercholesterolemia: Focus on Colesevelam

2010

Clinical Medicine Reviews in Vascular Health

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Background: Statins are recommended as first line therapy for the prevention of cardiovascular disease. Some individuals are statin intolerant or may need additional cholesterol lowering to achieve their cholesterol targets. Purpose: To review the pharmacology, clinical efficacy and safety of colesevelam mono-and combination therapy in patients with hypercholesterolemia. Data source: English-language journals from PUBMED MEDLINE (without restriction of date) using key word colesevelam. Results: Trials of colesevelam as monotherpy or in combination had baseline LDL-c levels of 130 to 202 mg/dl and triglycerides levels of 114 to 230 mg/dl. Colesevelam monotherapy reduced LDL-c by 9%-20% while increasing triglycerides 6%-25%. When added to low or moderate dose statin therapy, colesevelam decreased LDL-c an additional 6%-16%; when added to fenofibrate, colesevelam additionally decreased LDL-c by 17% and non-HDL-c by 7%; and when added to statin + niacin 2 gr additionally decreased LDL-c by 10%. The hypertriglyceridemia observed with colesevelam monotherapy was largely attenuated when colesevelam was coadministered with statins, fenofibrate, or niacin 2 gr. Coadministration of colesevelam with ezetimibe provided variable additional LDL-c reductions ranging from 0 to 20% over ezetimibe alone, and triglyceride responses were similarly variable. In diabetic individuals with modest hypertriglyceridemia, colesevelam reduced hemoglobin A1c by 0.5%. Colesevelam has fewer drug interactions than older bile acid sequestrants and is well-tolerated when used in combination with other lipid-lowering medications as well as with oral anti-diabetes medications or insulin. Conclusion: Colesevelam is an option for patients who have not achieved their LDL-c and non-HDL-c goals with statin therapy, or who are statin intolerant. Colesevelam is also an option to lower both LDL-c and glucose levels in patients with inadequately controlled diabetes.

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Colesevelam HCl and Ezetimibe Combination Therapy Provides Effective Lipid-Lowering in Difficult-to-Treat Patients with Hypercholesterolemia

Cited by 53 publications

References 10 publications

Statin-Associated Muscle Adverse Events: Update for clinicians

Statin-Associated Muscle Adverse Events: Update for clinicians

Management of Familial Hypercholesterolemias in adult patients: Recommendations from the National Lipid Association Expert Panel on Familial Hypercholesterolemia

Current and Emerging Therapies in Hypercholesterolemia: Focus on Colesevelam

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