ZETELD results show efficacy of atorvastatin plus ezetimibe in elderly
MedWire News: Addition of ezetimibe to low-dose atorvastatin improves the lipid profile of elderly individuals at high risk for coronary heart disease (CHD) to a significantly greater extent than increasing the dose of atorvastatin, report researchers.
The ZETia in the ELDerly (ZETELD) Study was a 12-week randomized controlled trial involving 1053 individuals aged 71 years on average recruited from sites in the USA, Canada, Russia, Romania, Ukraine, and Poland. All the participants were considered to be at high risk for CHD.
The investigators assigned the participants to take atorvastatin 10 mg/day plus ezetimibe 10 mg/day (n=526) or atorvastatin 20–40 mg/day (n=527).
Franklin Zieve (McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA) and colleagues found that at 12 weeks 43.6% of the patients treated with atorvastatin plus ezetimibe had achieved a low-density lipoprotein (LDL) cholesterol level of below 70 mg/dl (1.81 mmol/l) compared with only 32.2% of those taking atorvastatin alone.
In a similar fashion, 49.4% and 39.3% of patients in the atorvastatin plus ezetimibe and atorvastatin treatment groups, respectively, achieved a target LDL cholesterol of below 100 mg/dl (2.59 mmol/l) for individuals without atherosclerotic disease and below 70 mg/dl (1.81 mmol/l) for those with atherosclerotic disease.
In addition, those in the atorvastatin plus ezetimibe group had significantly improved levels of non-high-density lipoprotein (HDL) cholesterol, apolipoprotein (apo) A-I, total cholesterol, apo B, and HDL cholesterol at 12 weeks compared with those taking atorvastatin alone.
“These results provide support for ezetimibe added to atorvastatin as a generally tolerable intensive lipid-altering therapy in patients aged 65 years or older seeking significant improvements in LDL cholesterol and other lipids for achievement of their optimal National Cholesterol Education Program Adult Treatment Panel III treatment targets,” conclude the authors.
“Clinical trials to assess cardiovascular outcomes with ezetimibe added to statin therapy are ongoing,” they add.
The results of this study are published in the American Journal of Cardiology.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Helen Albert