Non-low-density lipoprotein cholesterol-associated actions of ezetimibe: an overview

Abstract

Ezetimibe, an intestinal cholesterol absorption inhibitor, lowers circulating low-density lipoprotein cholesterol (LDL-C) levels both when administered as monotherapy and in combination with other hypolipidaemic drugs, mostly statins. This review focuses on the effects of ezetimibe on non-LDL-C-associated variables. In most studies, ezetimibe effectively reduced triglyceride and increased high density lipoprotein cholesterol levels. The authors also consider the effect of ezetimibe on other variables such as C-reactive protein levels, insulin sensitivity and endothelial function. Ezetimibe is useful in patients with sitosterolaemia (a rare inherited disorder) as it significantly reduces plasma phytosterol concentrations. Ezetimibe fulfils two of the three essential characteristics of any drug (efficacy and safety). However, clinical studies are required to provide evidence of its ability to reduce vascular events.

Keywords::

• c-reactive protein
• ezetimibe
• high-density lipoprotein cholesterol
• sitosterolaemia
• statin
• triglyceride

Acknowledgements

Dr Gazi is supported by a grant from the Hellenic Atherosclerosis Society. This review was conducted independently; no company or institution supported it financially. The authors have given talks, attended conferences and participated in trials and advisory boards sponsored by various pharmaceutical companies.