Ezetimibe 10 mg daily reduces CVD events

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Goodfellow Gems

"Ezetimibe 10 mg daily reduces CVD events; NNT = 50"

Until the IMPROVE-IT (2014) trial it was known that Ezetimibe lowered LDL (albeit less so that with statins) but evidence of benefit was not forthcoming. This is the first trial to definitively show a health benefit for ezetimibe.

This study shows that in acute coronary syndrome patients, adding ezetimibe to 40 mg of simvastatin prevents one cardiovascular (CVD) event for every 50 people with acute coronary syndrome (within 10 days and with LDL 1.3-3.2 mmol/L) treated for seven years. There was no difference in mortality but a significantly reduced CVD: 32.7% vs 34.7%.

In those who tolerate statins it may be simpler to increase the dose to help achieve a target. Ezetimibe alone will be useful in patients who cannot tolerate statins.

  1. http://my.americanheart.org/idc/groups/ahamah-public/@wcm/@sop/@scon/documents/downloadable/ucm_469669.pdf
  2. http://www.acfp.ca/wp-content/uploads/tools-for-practice/1422311936_update-ezetimibe-tfp23fv.pdf

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.


As published in NZ Doctor 16/03/2015