A comparison of efficacy and safety of an ezetimibe/simvastatin combination compared with other intensified lipid-lowering treatment strategies in diabetic patients with symptomatic cardiovascular disease

The low-density lipoprotein cholesterol (LDL-C) lowering efficacy of switching to ezetimibe/ simvastatin(EZ/S) 10/20 mg versus doubling the run-in statindose (to simvastatin40 mg or atorvastatin20 mg) or switching to rosuvastatin10 mg in subjects with cardiovascular disease (CVD) and diabetes was assessed. Endpoints included percentage change in LDL-C and percentage of patients achieving LDL-C <70 mg/dL. Significantly greater reductions in LDL-C occurred when switching to EZ/S versus statindoubling in the overall population and in subjects treated with simvastatin20 mg or atorvastatin10 mg (all p < 0.001). The LDL-C reduction was numerically greater when switching to EZ/S versus switching to rosuvastatin(p = 0.060). Significantly more subjects reached LDL-C <70 mg/dL with EZ/S (54.5%) versus statindoubling (27.0%) or rosuvastatin(42.5%) in the overall population (all p < 0.001) and within each stratum (all p < 0.001). Switching to EZ/S provided significantly greater reductions in LDL-C versus statindoubling and significantly greater achievement of LDL-C targets versus statindoubling or switching to rosuvastatin.