Key result
The single-pill combination of rosuvastatin 10 mg and ezetimibe 10 mg significantly reduced LDL-C by an additional 13.85% compared to rosuvastatin 10 mg alone at 8 weeks.
Why the study?
Many Chinese patients with primary hypercholesterolemia do not reach LDL-C goals with recommended-dose statin monotherapy.
Does a single-pill combination of rosuvastatin 10 mg and ezetimibe 10 mg improve LDL-C reduction compared to rosuvastatin 10 mg alone in Chinese patients with primary hypercholesterolemia inadequately controlled by statin therapy?
RCT (n=305)
Double-blind, double-dummy
1:1
Yes
Does a single-pill combination of rosuvastatin 10 mg and ezetimibe 10 mg improve LDL-C reduction compared to rosuvastatin 10 mg alone in Chinese patients with primary hypercholesterolemia inadequately controlled by statin therapy?
Mean Difference: -13.85 (95% CI -20.15–-7.56)
Absolute Event Rate: -21.98% vs -8.12%
p-value: p=<0.0001
Supports SPC R10/E10 for Chinese patients not at LDL-C goal on statin; extends phase 3 RCT evidence for ezetimibe add-on.
INTRODUCTION: Many patients with primary hypercholesterolemia do not achieve their plasma low-density lipoprotein cholesterol (LDL-C) goals with statin alone under a recommended dose of statin (e.g., 10 mg rosuvastatin) in China. The objective of this phase III study was to evaluate the efficacy and safety of a new single-pill combination (SPC) of rosuvastatin 10 mg/ezetimibe 10 mg (R10/E10) in this population. METHODS: This was a randomized, double-blind, double-dummy, active-controlled study in patients with primary hypercholesterolemia inadequately controlled with statin alone. The participants were randomized 1:1 to receive SPC R10/E10 or R10. The primary objective was to demonstrate the superiority of SPC R10/E10 vs. R10 in reducing the LDL-C levels after 8 weeks. RESULTS: This trial randomized 305 participants to SPC R10/E10 (n = 153) and R10 (n = 152). The superiority of SPC R10/E10 over R10 was demonstrated with the least square (LS) mean difference of percent change in LDL-C from baseline to week 8: - 13.85% (95% confidence interval [CI] - 20.15% to - 7.56%, P < 0.0001). The proportion of participants who achieved the LDL-C target (< 2.6 mmol/l) at week 8 was larger with SPC R10/E10 (n = 80, 54.1%) than with R10 (n = 42, 29.2%) (Odds ratio = 2.80, 95% CI 1.70 to 4.61, P < 0.0001). No unexpected safety findings were reported. CONCLUSION: The results suggest that SPC R10/E10 improve LDL-C reduction and goal achievement in Chinese patients with primary hypercholesterolemia not adequately controlled on statin therapy, without new safety findings. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04669041).
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Su et al. (2023) conducted an RCT in Primary hypercholesterolemia (n=305). Single-pill combination of rosuvastatin and ezetimibe vs. Rosuvastatin 10 mg was evaluated on Percent change in LDL-C from baseline to week 8 (MD -13.85%, 95% CI -20.15% to -7.56%, p=<0.0001). The single-pill combination of rosuvastatin 10 mg and ezetimibe 10 mg significantly reduced LDL-C by an additional 13.85% compared to rosuvastatin 10 mg alone at 8 weeks.
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