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ACC: No Benefit Seen with Zetia's Extra Lipid-Lowering

Second study compares prescribing patterns in United States and Canada

MONDAY, March 31 (HealthDay News) -- A study showing that combination treatment with ezetimibe (Zetia) and a statin does not reduce progression of atherosclerotic disease compared to a statin alone, and an article comparing ezetimibe prescribing patterns in the United States and Canada are among the research findings published online March 30 in the New England Journal of Medicine. These results and implications were discussed this week at the American College of Cardiology's 57th Scientific Session in Chicago.

Cynthia Jackevicius, of the University of Toronto in Canada, and colleagues studied ezetimibe prescribing practices in the United States and Canada using data from IMS Health. Between 2002 and 2006, the proportion of ezetimibe prescriptions among all lipid-lowering agents prescribed rose from 0.1 percent to 15.2 percent in the United States, but only from 0.2 percent to 3.4 percent in Canada.

In a second study, John J.P. Kastelein, M.D., Ph.D., of the Academic Medical Center in Amsterdam, the Netherlands, and colleagues randomized 720 patients with familial hypercholesterolemia to receive 80 mg simvastatin daily either with 10 mg ezetimibe or placebo for 24 months. While combination therapy led to greater reductions in low-density lipoprotein (LDL) cholesterol levels, the rate of progression of atherosclerotic disease, measured by carotid-artery intima-media thickness, did not differ between the two groups.

The author of an associated editorial hypothesizes about the observed lack of benefit of ezetimibe's additional lipid-lowering: "These findings plus future biologic and clinical evidence could confirm that the benefits of lowering LDL cholesterol may depend not only on 'how low you go' but also on 'how you get there.'"

The study by Kastelein was supported by Merck and Schering-Plough, and the authors reported financial ties to these and other pharmaceutical companies.

Abstract -- Jackevicius
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Abstract -- Kastelein
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