Efficacy Of Ezetimibe Plus Low Dose Simvastatin Versus High Dose Statin: A Meta-analysis

Objective: To compare the effect of the combination low-dose simvastatin and ezetimibe(Ezetimibe/simvastatin 10/10mg)with high dose statin on lipid-lowering treatment in patients of dyslipidemia.Methods: We found eight databases(Pubmed,Embase,Cochrane,Web of science,Clinicaltrials.gov,Wangfang,CNKI,Vip)by a systematic search way.Completely published Randomized Controlled Trials comparing the effect of high-dose statin(S)with Ezetimibe/simvastatin 10/10mg(E/S)on the lipid-lowering treatment were included in this study.Results: A total of 10 Randomized Controlled Trial(RCT)met inclusion criteria,including 1624 patients(E/S :691;S:933).Six outcome were pooled analysis,including weighted mean difference from baseline in total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),non high-density lipoprotein cholesterol(non-HDL-C),low-density lipoprotein cholesterol(LDL-C),triglyceride(TG)and high sensitivity C-reactive protein(hs-CRP).There was no significant gap between high-dose statin with Ezetimibe/simvastatin 10/10 mg in LDL-C(-1.55;95% confidence interval [CI]:-4.42~1.31,P=0.29),HDL-C(1.05;95% confidence interval [CI]:-0.21~2.3,P=0.1),TG(4.03;95% confidence interval [CI]:-4.53~12.58,P=0.36),hs-CRP(0.14;95% confidence interval [CI]:-0.50~0.78,P=0.67).There was difference between 2 lipid-lowering treatment in TC(-0.45;95% confidence interval [CI]:-9.07~-0.83,P=0.02),non-HDL-C(-4.97;95% confidence interval [CI]:-8.46~-1.49,P=0.005).Conclusions: Ezetimibe coadministered with simvastatin(10mg)and a high dosage of statin monotherapy may show similar effective in increasing HDL-C and reducing TG,LDL-C,hs-CRP.However,the results suggest that greater TC and non-HDL-C lowering with high dose statin monotherapy compared with ezetimibe/simvastatin.