Efficacy of combination of ezetimibe and simvastatin versus atorvastatin in reducing low density lipoprotein-cholesterol in male patients of hypercholesterolemia, at Bahawalpur

ABSTRACT

To see the efficacy of reducing Low-Density Lipoprotein cholesterol [LDL-C] with the combination of Ezetimibe/Simvastatin compared with Atorvastatin monotherapy in the local patients of hypercholesterolemia. This was a single-blind, randomized, uncontrolled, study [6 weeks of active treatment with Step 1 dietary advice and a 3 week wash out period]. Patients with hypercholesterolemia were randomized by an equal allocation to 2 treatment groups Ezetimibe/Simvastatin [10/10 mg] and Atorvastatin [20mg]. Two hundred and nineteen [219] men came for follow up after 6 week treatment when their lipid levels were compared to those at the start of treatment to calculate the efficacy measures; the percent change from baseline to the end of the 6-week treatment period in LDL-C levels and the percentage of patients who achieved the treatment goals for LDL-C levels after 6 weeks of treatment. LDL-C concentrations [in milligram per deciliter] were calculated by using Friedewald equation. The subjects having Coronary Heart Disease [CHD], Diabetes Mellitus [DM], metabolic syndrome, thyroid disease, chronic renal disease and hepatic disease were excluded from the sample. Mean percentage change from baseline in LDL-cholesterol levels after 6 week treatment with the combination therapy was found significantly superior to that with the monotherapy. There is significant [P<0.01] advantage of the combination therapy over the monotherapy for the achievement of LDL-C levels reductions below the clinical cut off value of 100mg/dl. Combining Ezetimibe with statins looks to be advantageous to the statins alone for LDL-C lowering in patients of hypercholesterolemia