Safety and efficacy of ezetimibe

A meta-analysis

Gianluigi Savarese, Gaetano M. De Ferrari, Giuseppe M C Rosano, Pasquale Perrone-Filardi

Research output: Contribution to journalArticle

33 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)247-252
Number of pages6
JournalInternational Journal of Cardiology
Volume201
DOIs
Publication statusPublished - Oct 10 2015

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Meta-Analysis
Safety
Hypolipidemic Agents
Stroke
Myocardial Infarction
Mortality
Randomized Controlled Trials
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Neoplasms
Ezetimibe
LDL Cholesterol
Placebos
Therapeutics

Keywords

  • Cardiovascular events
  • Cholesterol
  • Ezetimibe
  • Mortality
  • Statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Safety and efficacy of ezetimibe : A meta-analysis. / Savarese, Gianluigi; De Ferrari, Gaetano M.; Rosano, Giuseppe M C; Perrone-Filardi, Pasquale.

In: International Journal of Cardiology, Vol. 201, 10.10.2015, p. 247-252.

Research output: Contribution to journalArticle

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title = "Safety and efficacy of ezetimibe: A meta-analysis",
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.",
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T2 - A meta-analysis

AU - Savarese, Gianluigi

AU - De Ferrari, Gaetano M.

AU - Rosano, Giuseppe M C

AU - Perrone-Filardi, Pasquale

PY - 2015/10/10

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N2 - 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.

AB - 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.

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KW - Cholesterol

KW - Ezetimibe

KW - Mortality

KW - Statins

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