The effect of a simvastatin and ezetimib combination on blood lipids and cardiovascular events in diabetic patients (comments on the subanalysis results within the IMPROVE-IT study)

Česká verzia

Authors: Vladimír Soška ^1,2,3
Authors place of work: Oddělení klinické biochemie a ICRC FN u sv. Anny v Brně, primář prof. MUDr. Vladimír Soška, CSc. ¹; II. interní klinika LF MU a FN u sv. Anny v Brně, přednosta prof. MUDr. Miroslav Souček, CSc. ²; Katedra laboratorních metod LF MU Brno, vedoucí katedry doc. MUDr. Milan Dastych, CSc., MBA ³
Published in the journal: Vnitř Lék 2015; 61(11): 965-969
Category: Reviews

Summary

IMPROVE-IT study demonstrated that the addition 10 mg of ezetimibe to 40 mg of simvastatin in patients after acute coronary syndrome reduces significantly not only their LDL-cholesterol, but also the number of cardiovascular events. Recently published subanalysis of this study was focused on whether these combinations of drugs is more preferable for patients with diabetes mellitus or for patients without diabetes. The addition of ezetimibe to a simvastatin resulted in a greater decline of LDL-cholesterol level in diabetic group than in patients without diabetes. In patients with diabetes mellitus their cardiovascular morbidity and mortality were decreased significantly; reduction of these clinical end-points in the group of patients without diabetes were not statistically significant.

Key words:
diabetes mellitus – ezetimibe – LDL-cholesterol – simvastatin

Zdroje

1. Baigent C, Blackwell L, Emberson J et al. Cholesterol Treatment Trialists’ (CTT) Collaboration. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials. Lancet. 2010; 376(9753): 1670–1681.

2. Vaverkova H. Dual inhibition of cholesterol using the drug combination ezetimibe/simvastatin? Vnitř Lék 2007; 53(4): 421–427.

3. Cannon CP, Blazing MA, Giugliano RP et al. Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes. N Engl J Med 2015; 372(25): 2387–2397.

4. Cannon CP, Giugliano RP, Blazing MA et al. Rationale and design of IMPROVE-IT (IMProved Reduction of Outcomes: Vytorin Efficacy International Trial): comparison of ezetimbe/simvastatin versus simvastatin monotherapy on cardiovascular outcomes in patients with acute coronary syndromes. Am Heart J 2008; 156(5): 826–832.

5. Perk J, De Backer G, Gohlke H et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33(13): 1635–1701.

6. Leiter LA, Lundman P, da Silva PM et al. Persistent lipid abnormalities in statin-treated patients with diabetes mellitus in Europe and Canada: results of the Dyslipidaemia International Study. Diabet Med 2011; 28(11): 1343–1351.

7. Gylling H, Miettinen TA. Cholesterol absorption and lipoprotein metabolism in type II diabetes mellitus with and without coronary artery disease. Atherosclerosis 1996; 126(2): 325–332.

8. Okada K, Yagyu H, Kotani K et al. Lipid-lowering effects of ezetimibe for hypercholesterolemic patients with and without type 2 diabetes mellitus. Endocr J 2010; 57(10): 903–908.

9. Ciriacks K, Coly G, Krishnaswami S et al. Effects of simvastatin and ezetimibe in lowering low-density lipoprotein cholesterol in subjects with type 1 and type 2 diabetes mellitus. Metab Syndr Relat Disord 2015; 13(2): 84–90.

10. Park SW. Intestinal and hepatic niemann-pick c1-like 1. Diabetes Metab J 2013; 37(4): 240–248. Erratum in Diabetes Metab J 2013; 37(6): 486–487.

11. Federici M. Effect of ezetimibe on cholesterol absorption and lipoprotein composition in diabetes and metabolic syndrome. Atheroscler Suppl 2015; 17: 17–22.

12. Ruggenenti P, Cattaneo D, Rota S et al. Effects of combined ezetimibe and simvastatin therapy as compared with simvastatin alone in patients with type 2 diabetes: a prospective randomized double-blind clinical trial. Diabetes Care 2010; 33(9): 1954–1956.

13. Tomassini JE, Mazzone T, Goldberg RB et al. Effect of ezetimibe/simvastatin compared with atorvastatin on lipoprotein subclasses in patients with type 2 diabetes and hypercholesterolaemia. Diabetes Obes Metab 2009; 11(9): 855–864.

14. Farnier M, Guyton JR, Jensen E et al. Effects of ezetimibe, simvastatin and ezetimibe/simvastatin on correlations between apolipoprotein B, LDL cholesterol and non-HDL cholesterol in patients with primary hypercholesterolemia. Atherosclerosis 2013; 229(2): 415–422.