Comparison of clinical effectiveness of ezetymib/simvastatin combination v. atorvastatin and rosuvastatin in achievement the Joint British Societies (JBS)-2 low density-lipoprotein cholesterol (LDL-C) target – UK General Practice Trial (IN-PRACTICE) Review article

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Agnieszka Wsół
Artur Mamcarz

Abstract

Aim: The aim of this study was to compare ezetimibe ⁄ simvastatin combination therapy with intensified statin monotherapy (atorvastatin and rosuvastatin) as alternative treatment strategies to achieve the Joint British Societies (JBS)-2 low density-lipoprotein cholesterol (LDL-C) target of <2 mmol/L for primary and secondary prevention in high-risk patients who have failed to reach target with pharamacotherapy with simvastatin 40 mg.


Methods: the IN-PRACTICE study was prospective, double-blind study. 1748 patients with established coronary artery disease (CAD), diabetes or high risk of CAD on at least 6 week duration therapy with simvastatin 40mg were enrolled to this study and 786 (45%) with fasting LDL-C >2,0 mmol/L (and <4,2 mmol/L) after further 6-week run-in period on simvastatin 40 mg were randomised to three groups receiving: ezetimibe⁄simvastatin (10⁄40 mg), atorvastatin (40 mg) or rosuvastatin (5–10 mg). The primary outcome of the study was proportion of study population that achieved LDL-C <2 mmol/L.


Results: The proportion of patients that achieved JBS-2 target was following: 69,4% with ezetimibe⁄simvastatin (10⁄40 mg) v. 33,5% for atorvastatin (40 mg) (p <0,001) and 14,3% for rosuvastatin (5–10 mg) (p <0,001). Authors observed similar results for reducing total cholesterol concentration (<4,0 mmol/L).


Conclusions: combined treatment with ezetimibe⁄simvastatin (10⁄40 mg) appeared to be more effective strategy in lowering LDL-C than intensification of statin monotherapy (atorvastatin 40 mg and rosuvastatin 5–10 mg).

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How to Cite
Wsół, A., & Mamcarz , A. (2010). Comparison of clinical effectiveness of ezetymib/simvastatin combination v. atorvastatin and rosuvastatin in achievement the Joint British Societies (JBS)-2 low density-lipoprotein cholesterol (LDL-C) target – UK General Practice Trial (IN-PRACTICE). Medycyna Faktow (J EBM), 3(3(8), 6-11. Retrieved from https://journalsmededu.pl/index.php/jebm/article/view/2571
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References

1. McCormack T., Harvey P., Gaunt R., Allgar V., Chipperfield R., Robinson P.; IN-PRACTICE study. Incremental cholesterol reduction with ezetimibe/simvastatin, atorvastatin and rosuvastatin in UK General Practice (IN-PRACTICE): randomised controlled trial of achievement of Joint British Societies (JBS-2) cholesterol targets. Int. J. Clin Pract. 2010; 64 (8): 1052-61.

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