Comparative efficacy of the addition of ezetimibe to statin vs statin titration in patients with hypercholesterolaemia: systematic review and meta-analysis
| العنوان: | Comparative efficacy of the addition of ezetimibe to statin vs statin titration in patients with hypercholesterolaemia: systematic review and meta-analysis |
|---|---|
| المؤلفون: | Dimitri P. Mikhailidis, Richard W. Lawson, Kaan Tunceli, Andrew M. Tershakovec, Gillian C. Sibbring, Anna-Louise McCormick, Glenn M. Davies |
| المصدر: | Current Medical Research and Opinion. 27:1191-1210 |
| بيانات النشر: | Informa Healthcare, 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | medicine.medical_specialty, Statin, medicine.drug_class, business.industry, Anticholesteremic Agents, Hypercholesterolemia, MEDLINE, General Medicine, Pharmacology, Ezetimibe, Clinical trial, Critical appraisal, Systematic review, Data extraction, Meta-analysis, Internal medicine, medicine, Azetidines, Humans, Drug Therapy, Combination, lipids (amino acids, peptides, and proteins), Hydroxymethylglutaryl-CoA Reductase Inhibitors, business, medicine.drug |
| الوصف: | To systematically review and analyse evidence for cholesterol-lowering efficacy of at least 4 weeks of add-on ezetimibe vs doubling statin dose, in adults with primary hypercholesterolaemia.MEDLINE, EMBASE and Cochrane databases were searched to identify randomised controlled trials of ezetimibe-statin combination vs statin titration (January 1993 - March 2010). Studies were selected using predefined criteria. Two reviewers conducted screening of articles, critical appraisal and data extraction; a third reviewer resolved disagreements. The difference between treatments was analysed for four co-primary outcomes: mean percentage change from baseline in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC); and proportion of patients achieving LDL-C treatment goal. Data were combined by two sets of direct comparison fixed and random effects meta-analysis: (1) compared data in the same treatment period between groups; (2) compared the incremental change in lipid levels of add-on ezetimibe vs doubling statin dose. Heterogeneity was assessed using the I(2) statistic.Thirteen studies including 5080 patients were included in the meta-analyses. Data on simvastatin, atorvastatin and rosuvastatin were analysed. Results for primary and secondary outcomes were in favour of the ezetimibe-statin combination. A significantly greater percentage reduction in LDL-C levels was achieved in patients treated with ezetimibe-statin vs statin monotherapy (weighted mean difference [WMD]: -14.1% [-16.1, -12.1], p 0.001). Reduction in LDL-C levels attributed to add-on ezetimibe was significantly greater than that for statin dose doubling (WMD: -15.3% [-19.1, -11.4], p 0.001). Achievement of LDL-C goal favoured add-on ezetimibe over statin titration and was statistically significant (odds ratio: LDL-C treatment goal 2.45 [1.95, 3.08], p = 0.007).Meta-analyses were restricted by the limited number of studies with similar trial design and method of statin titration. Results indicate that add-on ezetimibe is significantly more effective in reducing LDL-C levels than doubling statin dose, enabling more patients to achieve LDL-C goal. |
| تدمد: | 1473-4877 0300-7995 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c47c4761f56b9cbbdc6444a05ccc5b07 https://doi.org/10.1185/03007995.2011.571239 |
| رقم الأكسشن: | edsair.doi.dedup.....c47c4761f56b9cbbdc6444a05ccc5b07 |
| قاعدة البيانات: | OpenAIRE |
PDF full text from Publisher | تدمد: | 14734877 03007995 |
|---|