Ezetimibe/Simvastatin Is More Effective Than Atorvastatin In Metabolic Syndrome

New data indicate that patients with metabolic syndrome have a greater likelihood of reaching specified lipid and high-sensitivity C-reactive protein (hs-CRP) levels if they are treated with ezetimibe/simvastatin than with atorvastatin.

The findings were announced at the 46^th European Association for the Study of Diabetes (EASD) meeting.

The investigators, from multiple centers worldwide, also found that combination therapy was effective in metabolic syndrome patients with and without atherosclerotic vascular disease (AVD).

Jeffrey B. Rosen, MD, Medical Director of Clinical Research of South Florida in Coral Gables, and colleagues determined the percentage of patients with and without AVD treated with ezetimibe/simvastatin combination therapy versus atorvastatin achieving specified lipid and hs-CRP levels.

The 1,143 adult patients enrolled in the trial were randomized to ezetimibe/simvastatin combination tablet 10/20 or 10/40 mg or atorvastatin 10, 20, or 40 mg for 6 weeks. All patients had metabolic syndrome and hypercholesterolemia and were at moderately high risk of coronary heart disease.

Prespecified dose comparisons were ezetimibe/simvastatin 10/20 mg versus atorvastatin 10 mg or 20 mg and ezetimibe/simvastatin 10/40 mg versus atorvastatin 40 mg.

The analysis showed that significantly more patients without AVD achieved the single low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C) and apolilipoprotein (Apo) B levels and the combination of these three levels with ezetimibe/simvastatin versus atorvastatin for the specified dose comparisons, except in the ezetimibe/simvastatin 40 mg versus atorvastatin 40 mg dose comparison.

Significantly more patients with AVD achieved the single LDL-C and non-HDL-C levels and the combined triple levels with ezetimibe simvastatin than with atorvastatin at all dose comparisons, and the single Apo B level only with the ezetimibe/simvastatin 10/20 mg versus atorvastatin 10 mg comparison.

In both subgroups, achievement of hs-CRP Jill Stein is a Paris-based freelance medical writer.