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Ezetimibe/Simvastatin Combo Lowers LDL in Type 2 Diabetes

In patients with high LDL despite simvastatin, ezetimibe found to be beneficial

FRIDAY, Sept. 3 (HealthDay News) -- For patients with type 2 diabetes who are not meeting recommended low-density lipoprotein (LDL) cholesterol goals, adding ezetimibe to simvastatin treatment significantly increases the likelihood of reaching an LDL cholesterol level below 70 mg/dL, according to a study published in the September issue of Diabetes Care.

Piero Ruggenenti, M.D., of the Mario Negri Institute for Pharmacological Research in Bergamo, Italy, and colleagues conducted a randomized, double-blind, placebo-controlled trial of ezetimibe 10 mg/day versus placebo in 108 patients with type 2 diabetes already taking simvastatin 40 mg/day; all of the participants had total cholesterol levels greater than 135 mg/dL, and all continued on simvastatin.

After two months, the researchers found that patients in the ezetimibe plus simvastatin group had significant improvements in their lipoprotein profile, with a reduction in total cholesterol from a mean of 162 to 124 mg/dL. Compared to the placebo group, LDL cholesterol and apolipoprotein B were also significantly decreased in the ezetimibe group: LDL cholesterol fell from a mean of 99 to 66 mg/dL, and apolipoprotein B decreased from a mean of 83 to 64 mg/dL. Seventy-two percent of the ezetimibe patients, versus 17 percent of the controls, reached LDL levels below 70 mg/dL.

"In conclusion, adding ezetimibe to simvastatin therapy helps improve the pro-atherogenic lipoprotein profile in type 2 diabetic patients while avoiding the drawbacks of maximizing statin doses," the authors write.

The study was funded by Merck Sharp & Dohme (Italia) SpA, which also supplied the study drugs.

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