Low‐density lipoprotein cholesterol reduction and target achievement after switching from statin monotherapy to statin/ezetimibe combination therapy: Real‐world evidence. (7th October 2020)

• Record Type: Journal Article
• Authors: Lee, Jeongmin; Lee, Sue Hyun; Kim, Hyunah; Lee, Seung‐Hwan; Cho, Jae Hyoung; Lee, Hyunyong; Yim, Hyeon Woo; Yoon, Kun‐Ho; Kim, Hun‐Sung; Kim, Ju Han
• Is Part Of: Journal of clinical pharmacy and therapeutics. Volume 46:Number 1(2021)
• Page Start: 134
• Page End: 142
• Publication Date: 2020-10-07
• Subjects: cholesterol -- dyslipidaemia -- ezetimibe -- hydroxymethylglutaryl‐CoA reductase inhibitors -- LDL; Clinical pharmacology -- Periodicals; Chemotherapy -- Periodicals; 615
• DOI: 10.1111/jcpt.13271
• Languages: English
• ISSNs: 0269-4727

Abstract

Abstract: What is known and objectives: This study investigated the additional low‐density lipoprotein cholesterol (LDL‐C) reductions and target (LDL‐C < 100 mg/dL) achievement rates in patients after switching from statin monotherapy to statin/ezetimibe combination therapy, in clinical practice. Methods: This retrospective study used data recovered from the electronic medical record systems of two tertiary care medical centres for patients treated between 2015 and 2017. Patients prescribed statin/ezetimibe combination therapy after switching from statin monotherapy were enrolled. The observed LDL‐C reductions and the percentage of patients achieving LDL‐C levels of <100 mg/dL, after 3 months of treatment, were assessed relative to baseline values. Results and discussion: A total of 4252 patients with prescriptions for statin/ezetimibe combination therapy were enrolled. Changing from statin monotherapy to the combination therapy resulted in additional LDL‐C level reductions of 31.0‐41.0% (all intensity groups, P < .01). Similarly, 88.3‐91.1% of the enrolled patients successfully achieved LDL‐C levels of <100 mg/dL (all intensity groups, P < .01). A subgroup analysis of patients with baseline LDL‐C levels ≥ 100 mg/dL showed that switching from moderate‐ or high‐intensity statin monotherapy to a rosuvastatin/ezetimibe combination showed greater LDL‐C reductions than did switching to an atorvastatin/ezetimibe combination, within the same statin intensity groups. What is new and conclusion: The present study provides real‐world evidence of the LDL‐C reduction benefits associated with statin/ezetimibe combinations in the clinical practice setting. The results also demonstrate that if statin monotherapy does not effectively help patients reach their target LDL‐C goals, changing to a statin/ezetimibe combination prescription may show enhanced LDL‐C‐lowering effects and improve the likelihood of achieving LDL‐C targets, in real practice. Abstract : Dyslipidaemia is a well‐established, major risk factor for atherosclerotic disease. There is a recommendation that more intense low‐density lipoprotein cholesterol (LDL‐C) management be implemented to achieve desired targets. LDL‐C reduction benefits are associated with statin/ezetimibe combinations in the clinical practice setting.