Statin-ezetimibe combo superior to monotherapy in preventing CVD in T2D patients

In patients with type 2 diabetes (T2D), moderate-intensity statin in combination with ezetimibe results in greater reductions in low-density lipoprotein cholesterol (LDL-C) and better prevention of adverse outcomes when compared with high-intensity statin monotherapy, suggests a study.

Researchers compared the effects of combination therapy of low- or moderate-intensity statins plus ezetimibe with high-intensity statin monotherapy on myocardial infarction (MI), stroke, and all-cause mortality in T2D patients using the Korean National Health Insurance claims database.

Patients aged ≥20 years with T2D and dyslipidemia were enrolled in this study. A propensity score-matched analysis was conducted to compare the combination therapy with the monotherapy. Finally, the researchers analysed the incidence of the composite outcomes (ie, MI, stroke, and all-cause death) and each component.

LDL-C levels (74 vs 80.8 mg/dL; p<0.001) and the incidence of the composite outcomes (hazard ratio, 0.85, 95 percent confidence interval, 0.74‒0.98) were significantly lower in patients treated with moderate-intensity statin plus ezetimibe than those treated with high-intensity statin monotherapy.

On the other hand, there was no significant difference noted in LDL-C levels and composite outcomes between low-intensity statin plus ezetimibe and high-intensity statin monotherapy.

“Adding ezetimibe to a moderate-intensity statin in patients with T2D has a greater LDL-C–lowering effect and greater primary prevention of composite outcomes than that of high-intensity statin monotherapy,” the researchers said.

“LDL-C‒lowering therapy is considerably important in preventing cardiovascular disease (CVD) among patients with diabetes,” they noted.