Fixed-dose combination of rosuvastatin and ezetimibe: treating hypercholesteremia according to cardiovascular risk

ABSTRACT

Introduction: Reducing low-density lipoprotein cholesterol (LDL-C) with lipid-lowering therapies has been associated with a decrease in the frequency of cardiovascular events.

Areas covered: A systematic search was conducted on PubMed (MEDLINE), using the MeSH terms [Rosuvastatin] + [Ezetimibe] + [Dyslipidemia] + [treatment]. Original data from clinical trials, prospective and retrospective studies and more useful reviews were selected.

Expert opinion: While statins continue to be the cornerstone of dyslipidemia management, many patients do not attain LDL-C targets with high-intensity statins alone. Rosuvastatin is a high-intensity statin with a low risk of adverse effects and drug–drug interactions and proven benefits in the prevention of cardiovascular disease. Rosuvastatin and ezetimibe have complementary mechanisms of action that enhance their ability to reduce LDL-C levels. Various studies have shown that the combination of rosuvastatin 10–40 mg and ezetimibe 10 mg enables considerable reductions in LDL-C (up to 60–75%) with a good safety profile in a broad spectrum of patients with hypercholesterolemia, including those at high risk and those with atherosclerotic cardiovascular disease. In addition, a fixed-dose combination of rosuvastatin and ezetimibe may improve adherence to medication. In this review, the available evidence on the combination of rosuvastatin and ezetimibe is updated.

KEYWORDS:

• Cholesterol
• combined therapy
• ezetimibe
• rosuvastatin

Acknowledgments

Writing and editorial assistance were provided by Content Ed Net (Madrid, Spain) with funding from Viatris Spain.

Declaration of interest

V. Barrios has declared receiving honoraria consultancies and/or lecturing fees from Mylan, MSD, Sanofi, Amgen, Servier, Almirall. C. Escobar has declared receiving honoraria for oral presentations and consultancy fees from Mylan, MSD, Sanofi, Amgen, Servier, Almirall. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Article highlights

• Attaining LDL-C goals is necessary in order to decrease cardiovascular burden, especially in high-/very-high-risk patients.

• Early primary prevention of cardiovascular disease with lipid-lowering therapy is associated with a substantial reduction in atherosclerotic cardiovascular risk in the following years.

• Statins continue to be the cornerstone of management of dyslipidemia, yet many patients do not attain recommended LDL-C targets with high-intensity statins alone.

• Rosuvastatin and ezetimibe have complementary mechanisms of action that enhance their ability to reduce LDL-C levels.

• The fixed-dose combination of rosuvastatin and ezetimibe may simplify treatment and improve adherence to medication, thus reducing the frequency of cardiovascular complications.

• The combination of rosuvastatin and ezetimibe is cost-effective.

Reviewer disclosures

One reviewer has declared consultancy to Astra Zeneca and Althera. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose

Additional information

Funding

This article was supported by Viatris Spain.