I have an opportunity to write about lipids and cardiovascular disease. From lower the better concept of treatning LDL levels to non HDL cholesterol and Apo-B and Apo A1 levels.Ezetimibe is a new drug that has come with a bang. How does it work?
Ezetimibe selectively inhibits the absorption of cholesterol by blocking the Niemann–Pick C1-like (NPCL)1 protein DNA receptor at the intestinal wall, which decreases cholesterol return to the liver, very similar to bile acid sequestrants. These two drugs, along with statins, all lower intracellular hepatic cholesterol levels and upregulate the LDL-receptor to enhance LDL-C clearance from plasma.
I have to introduce you to ENHANCE study published in NEJM. ENHANCE found that adding ezetimibe to high-dose simvastatin therapy had no significant effect on carotid intima media thickness (CIMT) in 720 subjects with familial hypercholesterolemia. Read more...
If you look at the study 80% patients who entered the study were already taking statins. These patients failed to show any difference from baseline( They have aleady have less CIMT thickness. But what happened to 20% of statin naive patients? read the study fully..
So the answer for my question is NO.
Ezetimibe selectively inhibits the absorption of cholesterol by blocking the Niemann–Pick C1-like (NPCL)1 protein DNA receptor at the intestinal wall, which decreases cholesterol return to the liver, very similar to bile acid sequestrants. These two drugs, along with statins, all lower intracellular hepatic cholesterol levels and upregulate the LDL-receptor to enhance LDL-C clearance from plasma.
I have to introduce you to ENHANCE study published in NEJM. ENHANCE found that adding ezetimibe to high-dose simvastatin therapy had no significant effect on carotid intima media thickness (CIMT) in 720 subjects with familial hypercholesterolemia. Read more...
If you look at the study 80% patients who entered the study were already taking statins. These patients failed to show any difference from baseline( They have aleady have less CIMT thickness. But what happened to 20% of statin naive patients? read the study fully..
So the answer for my question is NO.
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