The Medical Letter on Drugs and Therapeutics
Ezetimibe Revisited
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In recent months, both the lay media and some medical experts have raised concerns about the effectiveness and safety of ezetimibe, a widely used drug that prevents absorption of cholesterol from the GI tract. Ezetimibe is available alone as Zetia and in combination with 10, 20, 40 and 80 mg of simvastatin (Zocor, and others) as Vytorin.

THE ENHANCE STUDY — The original basis of these concerns was a 2-year study in patients with familial hypercholesterolemia comparing the effects of ezetimibe and simvastatin together with those of simvastatin alone.1 The results showed no additional effect of ezetimibe on carotid intima-media thickness (IMT), a surrogate marker for coronary atherosclerosis, despite a reduction of 58% in LDL cholesterol (LDL-C) with the combination compared to a reduction of 41% with simvastatin alone.2

SURROGATE ENDPOINTS — ... more      

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