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02-02-2011 | Cardiometabolic | Article

Ezetimibe does not boost statin effect of sdLDL


Free abstract

MedWire News: Combining a statin with ezetimibe has similar effects on small dense low-density lipoprotein (sdLDL) concentration and LDL particle size as statin treatment alone in patients with primary hypercholesterolemia, research suggests.

Moses Elisaf (University of Ioannina, Greece) and colleagues show that ezetimibe/simvastatin combination therapy and simvastatin monotherapy both induced favorable changes in lipid profiles of hypercholesterolemic patients, with similar decreases in sdLDL cholesterol concentration and increases in LDL particle size.

The researchers randomly assigned 100 patients with LDL cholesterol levels above those recommended by the National Cholesterol Education Program Adult Treatment Panel III to receive simvastatin 40 mg or simvastatin/ezetimibe 10/10 mg daily.

After 3 months of treatment, LDL particle size, sdLDL cholesterol levels, and lipid profiles were assessed and compared to baseline measurements.

The team found that both simvastatin mono- and combination therapy decreased total cholesterol (31% and 36%, respectively), LDL cholesterol (43% and 49%), triglyceride (17% and 19%), non high-density lipoprotein (nonHDL) cholesterol (40% and 46%), large LDL cholesterol (40% and 44%), and sdLDL cholesterol levels (42% and 46%), and increased LDL particle size (0.5% and 0.7%).

The researchers report that changes in triglyceride, large LDL cholesterol, and sdLDL cholesterol levels, and LDL particle size were statistically similar between the two groups, whereas changes in total cholesterol, LDL cholesterol, and nonHDL cholesterol were significantly greater in the simvastatin/ezetimibe group.

Furthermore, baseline sdLDL cholesterol and triglyceride levels, but not treatment type, significantly and independently correlated with changes in sdLDL cholesterol levels.

Writing in the journal Current Medical Research and Opinion, the authors say: "Taking into account that simvastatin/ezetimibe 10/10 mg resulted in similar or even more favorable changes in lipid parameters compared with simvastatin 40 mg, this combination seems to be a useful option for hypercholesterolemia treatment in everyday clinical practice."

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Nikki Withers