Benefit of Ezetimibe Added to Simvastatin in Reduced Kidney Function

Journal of the American Society of Nephrology : JASN
John W StaniferMichael A Blazing

Abstract

Efficacy of statin-based therapies in reducing cardiovascular mortality in individuals with CKD seems to diminish as eGFR declines. The strongest evidence supporting the cardiovascular benefit of statins in individuals with CKD was shown with ezetimibe plus simvastatin versus placebo. However, whether combination therapy or statin alone resulted in cardiovascular benefit is uncertain. Therefore, we estimated GFR in 18,015 individuals from the IMPROVE-IT (ezetimibe plus simvastatin versus simvastatin alone in individuals with cardiovascular disease and creatinine clearance >30 ml/min) and examined post hoc the relationship of eGFR with end points across treatment arms. For the primary end point of cardiovascular death, major coronary event, or nonfatal stroke, the relative risk reduction of combination therapy compared with monotherapy differed by eGFR (P=0.04). The difference in treatment effect was observed at eGFR≤75 ml/min per 1.73 m2 and most apparent at levels ≤60 ml/min per 1.73 m2 Compared with individuals receiving monotherapy, individuals receiving combination therapy with a baseline eGFR of 60 ml/min per 1.73 m2 experienced a 12% risk reduction (hazard ratio [HR], 0.88; 95% confidence interval [95% CI], 0.82 to 0.95);...Continue Reading

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Citations

Nov 28, 2018·The Cochrane Database of Systematic Reviews·Shipeng ZhanXiaojiao Wu
Feb 2, 2019·Current Pharmaceutical Design·Michele ScognamiglioClaudio Napoli
Jul 26, 2019·Expert Opinion on Pharmacotherapy·Niki KatsikiMaciej Banach
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Oct 1, 2019·European Journal of Pharmacology·Niloufar MohammadkhaniEberhard Korsching
Aug 28, 2021·Journal of Personalized Medicine·Mengyuan GeAlessia Fornoni

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