Abstract
Background
The addition of ezetimibe to statin therapy has been widely demonstrated to significantly
reduce low-density lipoprotein cholesterol levels. However, the efficacy of ezetimibe
in reducing CV events and its safety has been less investigated. The aim of the current
meta-analysis was to report efficacy and safety of ezetimibe from randomized clinical
trials.
Methods
Randomized clinical trials with a follow-up of at least 24 weeks, enrolling more than 200 patients, comparing ezetimibe versus placebo or ezetimibe
plus another hypolipidemic agent versus the same hypolipidemic drug alone and reporting
at least one event among all-cause and CV mortality, myocardial infarction (MI), stroke
and new onset of cancer were included in the analysis.
Results
7 trials enrolling 31,048 patients (median follow-up 34.1 ± 26.3 months; 70% women; mean age 61 ± 8 years) were included in the analysis. Compared to control therapy, ezetimibe significantly
reduced the risk of MI by 13.5% (RR: 0.865, 95% CI: 0.801 to 0.934, p < 0.001) and the risk of any stroke by 16.0% (RR: 0.840, 95% CI: 0.744 to 0.949, p = 0.005), without any effect on all-cause and CV mortality (RR: 1.003, 95% CI: 0.954
to 1.055, p = 0.908; RR: 0.958, 95% CI: 0.879 to 1.044, p = 0.330; respectively) and risk of new cancer (RR: 1.040, 95% CI: 0.965 to 1.120, p = 0.303).
Conclusions
Ezetimibe significantly reduces the risk of MI and stroke without any effect on all-cause
and CV mortality and risk of cancer.
Keywords
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Article info
Publication history
Published online: August 10, 2015
Accepted:
August 9,
2015
Received in revised form:
July 24,
2015
Received:
June 8,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.