Ezetimibe in the Treatment of Patients with Metabolic Diseases

Abstract

55dyslipidemia along with hypertension, obesity, and cigarette smoking are established risk factors for premature heart disease. 1 The third report of the National cholesterol Education Program adult Treatment Panel (NcEP aTP iii) recommends a low-density lipoprotein cholesterol (ldl-c) goal of <2.6 mmol/l (<100 mg/dl) for patients with high risk for coronary artery disease (cad) or cad risk equivalent and <3.4 mmol/l (<130 mg/dl) for patients with moderate risk for cad. 2,3 although statins have been shown to be effective in lowering ldl-c and decreasing mortality, 4 40-80 % of individuals on statin monotherapy fail to achieve guideline-recommended ldl-c levels, with the lowest success rate for ldl-c goal achievement seen in patients with the highest risk for cad. Abstract dyslipidemia is an established risk factor for cardiovascular disease. While statin therapy remains the most important component of dyslipidemia management, a substantial proportion of patients on statin monotherapy fails to achieve guideline-recommended lipid levels. Ezetimibe is a secondline lipid-lowering agent that reduces sterol absorption, and has a favorable effect on lipid profile. This article reviews studies examining the role of ezetimibe on lipid profile, metabolic biomarkers, and cardiovascular outcomes in individuals with metabolic diseases. Special focus is given to studies in patients with dyslipidemia, Type 2 diabetes, and the metabolic syndrome. The controversy surrounding the role of ezetimibe in mitigating atherosclerosis is also highlighted. The article concludes that the ezetimibe-statin combination improves lipid parameters and helps attain guidelinerecommended lipid goals in patients with metabolic diseases. however, further research is needed to better understand the role of ezetimibe monotherapy, and the impact of ezetimibe on clinical cardiovascular outcomes. Keywords dyslipidemia, ezetimibe, metabolic diseases, atherosclerosisDisclosure: The authors have no conflicts of interest to declare. What is Ezetimibe?Ezetimibe is a lipid-lowering agent that prevents sterol absorption by selectively inhibiting the Niemann Pick c1 like 1 Protein (NPc1l1) at the jejunal brush border.

Role of Ezetimibe and Statins in Dyslipidemia Patients

“…It is mostly metabolised by the liver and eliminated in the faeces, and most people who use it report no serious adverse effects. A significant reduction in LDL-C levels was produced by the combination of ezetimibe and statin therapy compared to doubling the dose of statin atorvastatin or simvastatin (17).…”