Efficacy and safety of ezetimibe plus atorvastatin therapy

Statin therapy is highly effective in reducing low-density lipoprotein cholesterol (LDL-C) and cardiovascular events; however, many high-risk patients on statin monotherapy do not achieve sufficient LDL-C lowering. Statin-dose uptitration, switching to more potent statins and/or addition of complementary lipid-lowering drugs has been recommended for these patients. Numerous clinical trials have shown that coadministration of statins with cholesterol absorption inhibitor, ezetimibe, improves LDL-C lowering and other lipid parameters more than statins alone, including doubling the statin dose. In clinical outcome trials, ezetimibe combined with simvastatin reduced ischemic events in high-risk patients with chronic kidney disease and aortic stenosis; the incremental benefit of LDL-C lowering when ezetimibe is added to statin therapy on cardiovascular risk reduction compared with statin monotherapy is currently being evaluated in an ongoing clinical trial. Recently, a fixed-dose combination of ezetimibe plus atorvastatin, a statin with greater potency than most other statins, was approved by the US FDA and offers a therapeutic option for high-risk patients who do not achieve recommended LDL-C levels on statin monotherapy. This article provides an update on the safety and efficacy of ezetimibe plus atorvastatin therapy.