Ten ways of using ezetimibe, or a brief guide to its use today

Czech version

Authors: Martin Šatný; Michal Vrablík
Authors‘ workplace: Centrum preventivní kardiologie, III. interní klinika – klinika endokrinologie a metabolismu 1. LF UK a VFN v Praze
Published in: AtheroRev 2019; 4(3): 181-184
Category:

Overview

Ezetimibe – a blocker of the absorption of cholesterol and plant sterols from the intestine and intrahepatic bile ducts – is considered an effective and safe possibility of further enhancing the effect of statins on blood lipid levels, especially LDL-cholesterol (LDL-C). It is a well-tolerated medication with very few side effects and can be used in combination with all available statins to achieve the desired LDL-C target levels. As a single agent, ezetimibe is known to reduce LDL-c levels by approximately 20%, while in combination with a statin, the reduction may be as high as twofold. As with statins, prescription of ezetimibe is based on evidence from clinical trials, especially the IMPROVE-IT study which has shown the greatest benefit of its use is in the high-risk patients, especially in those with type 2 diabetes mellitus. In general, ezetimibe is useful where LDL-C target levels cannot be achieved with the maximum dose or the maximum tolerated dose of statins. The prescription of ezetimibe has now been approved for all medical specialties, including general practitioners, therefore a gradual increase of its use may be expected since it has frequently been a little appreciated lipid-lowering drug until now.

Keywords:

LDL-cholesterol – cardiovascular disease – NPC1L1-protein

Sources

Šnejdrlová M, Vrablík M. Ezetimib v éře přicházejících PCSK-9 inhibitorů. Hypertenze a KV prevence 2018; 7(2): 112–117. Dostupné z: WWW: <http://www.hypertension.cz/sqlcache/csh-casopis-2–2018.pdf>.
Adachi H, Nakano H, Yamamoto K et al. Ezetimibe ameliorates atherogenic lipids profiles, insulin resistance and hepatocyte growth factor in obese patients with hypercholesterolemia. Lipids Health Dis 2015; 14: 1. Dostupné z DOI: <http://dx.doi.org/10.1186/1476–511X-14–1>.
Kotani K, Sakane N, Taniguchi N. Effect of ezetimibe on remnant-like particle cholesterol in subjects with metabolic syndrome. Med Princ Pract 2012; 21(2): 134–138. Dostupné z DOI: <http://dx.doi.org/10.1159/000332436>.
Averna M. The effect of ezetimibe on NAFLD. Atheroscler Suppl 2015; 17: 27–34. Dostupné z DOI: <http://dx.doi.org/10.1016/S1567–5688(15)50007-X>.
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. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1410489>.
Rossebø AB1, Pedersen TR, Boman Ket al. Intensive Lipid Lowering with Simvastatin and Ezetimibe in Aortic Stenosis. N Engl J Med 2008; 359(13), 1343–1356. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa0804602>.
Baigent C, Landray MJ, Reith C et al. The effects of lowering LDL cholesterol with simvastatin plus ezetimibe in patients with chronic kidney disease (Study of Heart and Renal Protection): a randomised placebo-controlled trial. Lancet 2011; 377(9784): 2181–2192. Dostupné z DOI: <http://dx.doi.org/10.1016/S0140–6736(11)60739–3>.
Soška V. Vliv kombinace simvastatinu s ezetimibem na krevní lipidy a na kardiovaskulární příhody u diabetiků (komentář k výsledkům subanalýzy studie IMPROVE-IT). Vnitř Lék 2015; 61(11): 965–969.
Ezetimib. Příloha č. 2 k rozhodnutí o změně sp. zn. sukls1093 57/2009. Dostupné z WWW: http://www.sukl.cz/download/spc/SPC1994.pdf.
Mach F, Baigent C, Catapano AL et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2019; pii: ehz455. Dostupné z DOI: <http://dx.doi.org/10.1093/eurheartj/ehz455>.
Rozhodnutí SÚKL, č.j. sukl193054/2019. Dostupné z internetu:<http://https://drive.google.com/file/d/1c_thwUSmZtvhL6pDMPzJ_MQu4hXwPPWO/view>.