The role of ezetimibe in LDL cholesterol goal attainment in very high risk patients: the rosuvastatin monotherapy looks to be insufficient

Márk, László; Paragh, György; Rácz, I

doi:10.1185/03007995.2011.606806

Cited by 7 publications

(4 citation statements)

References 5 publications

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“…The Hungarian CORVUS (COntrolled TaRgets for High Vascular Risk Patients Using Effective Statins) trial included 1385 subjects, 1077 of whom were at very high risk, taking rosuvastatin monotherapy. 15 While 58% of the total population achieved the 100 mg/dL LDL-C target, only 19% of the very-high-risk subjects reached their <70 mg/dL target after taking rosuvastatin for 3 months. Treatment with ezetimibe combined with a higher potency statin has been shown to produce greater achievement of LDL-C targets.…”

Section: Discussionmentioning

confidence: 99%

A comparison of efficacy and safety of an ezetimibe/simvastatin combination compared with other intensified lipid-lowering treatment strategies in diabetic patients with symptomatic cardiovascular disease

Rosen

Jimenez²,

Pīrāgs

et al. 2013

Diabetes and Vascular Disease Research

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The low-density lipoprotein cholesterol (LDL-C) lowering efficacy of switching to ezetimibe/simvastatin (EZ/S) 10/20 mg versus doubling the run-in statin dose (to simvastatin 40 mg or atorvastatin 20 mg) or switching to rosuvastatin 10 mg in subjects with cardiovascular disease (CVD) and diabetes was assessed. Endpoints included percentage change in LDL-C and percentage of patients achieving LDL-C <70 mg/dL. Significantly greater reductions in LDL-C occurred when switching to EZ/S versus statin doubling in the overall population and in subjects treated with simvastatin 20 mg or atorvastatin 10 mg (all p < 0.001). The LDL-C reduction was numerically greater when switching to EZ/S versus switching to rosuvastatin (p = 0.060). Significantly more subjects reached LDL-C <70 mg/dL with EZ/S (54.5%) versus statin doubling (27.0%) or rosuvastatin (42.5%) in the overall population (all p < 0.001) and within each stratum (all p < 0.001). Switching to EZ/S provided significantly greater reductions in LDL-C versus statin doubling and significantly greater achievement of LDL-C targets versus statin doubling or switching to rosuvastatin.

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Section: Discussionmentioning

confidence: 99%

A comparison of efficacy and safety of an ezetimibe/simvastatin combination compared with other intensified lipid-lowering treatment strategies in diabetic patients with symptomatic cardiovascular disease

Rosen

Jimenez²,

Pīrāgs

et al. 2013

Diabetes and Vascular Disease Research

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“…The ezetimibe proved to be an efficient drug not only n lowering LDL-C but in the reduction of the clinical events too [23]. Its more frequent use of would be another possible source of further improvement [24,25].…”

Section: Resultsmentioning

confidence: 99%

Statin Therapy in Patients with Type 2 Diabetes Mellitus in Hungary

Márk

Rácz

Paragh

et al. 2015

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Aim:The benefit of statin administration in the secondary prevention of cardiovascular diseases in type 2 diabetes mellitus (T2DM) is well documented. The aim of the study was to evaluate the characteristics of lipid lowering therapy and the attainment of target values. Study Design: Retrospective data analysis. Place and Duration of Study: Between 2009 and 2011, Hungary. Methodology: The study was conducted on the patients with T2DM and established cardiovascular events of general practitioners and specialists from the MULTI GAP (MULTI Goal Attainment Original Research Article 148Problem) survey in Hungary using standardized, structured questionnaires. Data collection was performed in 2009 (1582 patients, 55.0% men), in 2010 (1159 patients, 58.4% men) and in 2011 (668 patients, 59.1% men). Results: In this study all patients received statins, the most frequently used was atorvastatin, followed in 2009 by simvastatin and 2011 by rosuvastatin. Fibrates were taken by 9.3-11.3% of patients and ezetimibe by 8.0-15.9% of patients. The total cholesterol (TC) values in 2009, in 2010 and in 2011 were 5.27±1.23 mmol/l, 4.90±1.30 mmol/l, 4.88±1.29 mmol/l, respectively (p>0.05). The LDL-cholesterol (LDL-C) values were 2.94±1.04 mmol/l, 2.73±0.95 mmol/l, 2.69±1.03 mmol/l, respectively (p>0.05). The proportion of patients at LDL-C target value of <2.5 mmol/l was 35.2%, 42.8%, 47.8% (p<0.001 vs values in 2009) while that of <1.8 mmol/l was 10.6%, 15.9% and 16.8%, respectively (p<0.001 vs values in 2009). There was a linear correlation between the patient compliance estimated by the physicians and the LDL-C achievement rate. Conclusions: In 2009-2011, a slight improvement in serum cholesterol levels and a significant increase of patients at target TC or LDL-C values were documented among patients with T2DM and cardiovascular diseases. Nevertheless, the authors find very important to improve the quality of lipid lowering treatment in order to increase the number of patients achieving their target lipid values.

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“…In this 3-month, multicenter, prospective, observational, non-interventional, open-label study during the treatment period the level of total cholesterol decreased by 25.2% and LDL cholesterol by 35.0%; at the end of the study the rate of achieving the 2.50 mmol/l LDL-C target level was 58%. One thousand and seventy-seven out of 1385 patients belonged to the very high risk category, and in this group of patients the 1.80 mmol/L LDL-C achievement rate proved to be only 19% [22, 23]. This result suggests that statin monotherapy, even in the case of the most potent rosuvastatin, in the majority of very high risk patients is ineffective and the administration of ezetimibe is inevitable.…”

Section: Discussionmentioning

confidence: 99%

How can we further improve the LDL-cholesterol target level achievement rate based on the Hungarian MULTI GAP 2011 study results and considering the new European dyslipidemia guidelines?

Márk¹,

Paragh²,

Karádi³

et al. 2012

aoms

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IntroductionDespite the continuous improvement of the quality of lipid lowering therapy the achievement of target values is still not satisfactory, mainly in the very high cardiovascular risk category patients, where the goal of low density lipoprotein cholesterol (LDL-C) is 1.80 mmol/l.Material and methodsThe trends in lipid lowering treatment of 17420 patients from different studies conducted between 2004 and 2010 were compared to that of 1626 patients of MULTI GAP (MULTI Goal Attainment Problem) 2011 treated by general practitioners (GPs) and specialists.ResultsIn MULTI GAP 2011 the mean LDL-C level ± SD) of patients treated by GPs was found to be 2.87 ±1.01 mmol/l, the target value of 2.50 was achieved by 40% of them, in the specialists’ patients the mean LDL-C level proved to be 2.77 ±1.10 mmol/l and the achievement rate was 45%. In the 2.50 mmol/l achievement rate of GPs’ patients a satisfactory improvement was observed in the studied years, but the 1.80 mmol/l LDL-C goal in 2011 was attained only in 11% of very high risk cases. There was a linear correlation between the patient compliance estimated by the physicians and the LDL-C achievement rate.ConclusionsAs the number of very high risk category patients has been increased according to the new European dyslipidemia guidelines, growing attention needs to be placed on attainment of the 1.80 mmol/l LDL-C level. Based on the results of the MULTI GAP studies, improving patients’ adherence and the continuous training of physicians are necessary.

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The role of ezetimibe in LDL cholesterol goal attainment in very high risk patients: the rosuvastatin monotherapy looks to be insufficient

Cited by 7 publications

References 5 publications

A comparison of efficacy and safety of an ezetimibe/simvastatin combination compared with other intensified lipid-lowering treatment strategies in diabetic patients with symptomatic cardiovascular disease

A comparison of efficacy and safety of an ezetimibe/simvastatin combination compared with other intensified lipid-lowering treatment strategies in diabetic patients with symptomatic cardiovascular disease

Statin Therapy in Patients with Type 2 Diabetes Mellitus in Hungary

How can we further improve the LDL-cholesterol target level achievement rate based on the Hungarian MULTI GAP 2011 study results and considering the new European dyslipidemia guidelines?

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