Response by sex to statin plus ezetimibe or statin monotherapy: A pooled analysis of 22,231 hyperlipidemic patients

Lipids in Health and Disease

Research

Pascale Benlian¹  Jianxin Lin²  Andrew M Tershakovec²  Arvind Shah²  Mary E Hanson²  Beth L Abramson³ 

[1] CHRU-Lille, Université Lille 2, Lille, France;Merck Sharp & Dohme Corp., Whitehouse Station, NJ, USA;St. Michael's Hospital, Toronto, Ontario, Canada;

关键词: low-density lipoprotein cholesterol;    hyperlipidemia;    ezetimibe;    statin;   

DOI  :  10.1186/1476-511X-10-146

 received in 2011-07-28, accepted in 2011-08-22,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundDespite documented benefits of lipid-lowering treatment in women, a considerable number are undertreated, and fewer achieve treatment targets vs. men.MethodsData were combined from 27 double-blind, active or placebo-controlled studies that randomized adult hypercholesterolemic patients to statin or statin+ezetimibe. Consistency of treatment effect among men (n = 11,295) and women (n = 10,499) was assessed and percent of men and women was calculated to evaluate the between-treatment ability to achieve specified treatment levels between sexes.ResultsBaseline lipids and hs-CRP were generally higher in women vs. men. Between-treatment differences were significant for both sexes (all p < 0.001 except apolipoprotein A-I in men = 0.0389). Men treated with ezetimibe+statin experienced significantly greater changes in LDL-C (p = 0.0066), non-HDL-C, total cholesterol, triglycerides, HDL-C, apolipoprotein A-I (all p < 0.0001) and apolipoprotein B (p = 0.0055) compared with women treated with ezetimibe+statin. The odds of achieving LDL-C < 100 mg/dL, apolipoprotein B < 90 mg/dL and the dual target [LDL-C < 100 mg/dL & apoliprotein B < 90 mg/dL] was significantly greater for women vs. men and the odds of achieving hs-CRP < 1 and < 2 mg/L and dual specified levels of [LDL-C < 100 mg/dL and hs-CRP < 2 mg/L] were significantly greater for men vs. women. Women reported significantly more gall-bladder-related, gastrointestinal-related, and allergic reaction or rash-related adverse events (AEs) vs. men (no differences between treatments). Men reported significantly more CK elevations (no differences between treatments) and hepatitis-related AEs vs. women (significantly more with ezetimibe+simvastatin vs. statin).ConclusionsThese results suggest that small sex-related differences may exist in response to lipid-lowering treatment and achievement of specified lipid and hs-CRP levels, which may have implications when managing hypercholesterolemia in women.

【 授权许可】

CC BY   
© Abramson et al; licensee BioMed Central Ltd. 2011