Eur Rev Med Pharmacol Sci 2019; 23 (5): 2302-2310

DOI: 10.26355/eurrev_201903_17279

A comparative meta-analysis of the efficacy of statin-ezetimibe co-therapy versus statin monotherapy in reducing cardiovascular and cerebrovascular adverse events in patients with type 2 diabetes mellitus

X.-Y. Miao, H.-Z. Liu, M.-M. Jin, B.-R. Sun, H. Tian, J. Li, N. Li, S.-T. Yan

Department of Endocrinology, The Second Medical Center & National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China. ystf@yeah.net


OBJECTIVE: This study evaluates the efficacy of statin-ezetimibe co-therapy compared to statin monotherapy in reducing cardiovascular and/or cerebrovascular disease (CVD) prevalence in diabetes and non-diabetes patients.

PATIENTS AND METHODS: Literature search was conducted in electronic databases and study selection was based on pre-determined eligibility criteria. Random-effects metanalyses were performed to examine the risk of CVD incidence between statin-ezetimibe co-therapy and statin monotherapy and subgroups were performed to examine the significance of differences between diabetic and non-diabetic individuals. A pooled analysis of hazard ratios of statin-ezetimibe combination versus statin monotherapy in the prevalence of CVD reported by the individual studies was also performed.

RESULTS: 8 studies (136893 individuals; 80790 diabetics, 85555 non-diabetics; age 63.5 years [95% confidence interval (CI) 61.2, 65.8]; 61.5% [95% CI 55.2, 67.8] males) were included. Follow-up duration was 45 months [95% CI 27.5, 62.5]. Risk of CVD prevalence was significantly less with ezetimibe-statin than with statin alone in both diabetes (RR 0.69 [95% CI 0.67, 0.73]; p<0.00001) and in non-diabetes (RR 0.68 [95% CI 0.52, 0.90]; p=0.006) subjects (subgroup difference: chi2=0.00; p=0.97). Risk of prevalence of stroke was significantly less with ezetimibe-statin than with statin monotherapy in diabetes (RR 0.74 [95% CI 0.56, 0.98]; p=0.03) but non-significantly less in non-diabetes patients (RR 0.74 [95% CI 0.39, 1.41]; p=0.39) and this sub-group difference was also not statistically significant (chi2=0.00; p=0.99).

CONCLUSIONS: Statin-ezetimibe co-therapy is found more efficacious than statin monotherapy in reducing the incidence of CVD with no significant difference between diabetic and non-diabetic individuals.

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X.-Y. Miao, H.-Z. Liu, M.-M. Jin, B.-R. Sun, H. Tian, J. Li, N. Li, S.-T. Yan
A comparative meta-analysis of the efficacy of statin-ezetimibe co-therapy versus statin monotherapy in reducing cardiovascular and cerebrovascular adverse events in patients with type 2 diabetes mellitus

Eur Rev Med Pharmacol Sci
Year: 2019
Vol. 23 - N. 5
Pages: 2302-2310
DOI: 10.26355/eurrev_201903_17279