Ezetimibe with Statins well tolerated in diabetic patients against CVD

Patients with diabetes mellitus (DM) in the RACING trial population tolerated the effects of ezetimibe and moderate-intensity statin combination medication, says and article published in European Heart Journal.

High-intensity statins are advised for patients who have concurrent diabetes and atherosclerotic cardiovascular disease (ASCVD), as they are thought to have an increased baseline risk for CVD events. Due to their side effects, high-intensity statins are often intolerable for many people. In order to compare the effectiveness of moderate-intensity statin with ezetimibe combination therapy to high-intensity statin monotherapy in patients with diabetes mellitus and atherosclerotic cardiovascular disease, Yong Jong Lee and team conducted this study.

This analysis of the DM cohort in the RACING study was done according to predetermined, stratified criteria. A 3-year composite of cardiovascular death, serious cardiovascular events, or non-fatal stroke was the main outcome.

The key findings of the study were:

1. 1398 patients overall (37.0%) had DM at baseline.

2. When patients with DM were randomly assigned to receive either high-intensity statin monotherapy or ezetimibe combination therapy, the rate of the primary outcome was 10.0% and 11.3%, respectively. 5.2% and 8.7% of patients in each group, respectively, discontinued or reduced their dose of the study medicine due to intolerance (P = 0.014).

3. 81.0%, 83.1%, and 79.9% of patients in the ezetimibe combination therapy program, and 64.1%, 70.2%, and 66.8% of patients in the high-intensity statin monotherapy group, respectively, had LDL cholesterol levels below 70 mg/dL at 1, 2, and 3 years (all P 0.001).

4. Regarding the primary endpoint, intolerance-related termination or dose reduction, and the percentage of patients with LDL cholesterol levels below 70 mg/dL, no significant interactions between DM status and medication were discovered in the entire group.

Reference:

Lee, Y.-J., Cho, J. Y., You, S. C., Lee, Y.-H., Yun, K. H., Cho, Y.-H., Shin, W.-Y., Im, S. W., Kang, W. C., Park, Y., Hong, M.-K., Jang, Y., & Kim, J.-S. (2022). Moderate-intensity statin with ezetimibe vs. high-intensity statin in patients with diabetes and atherosclerotic cardiovascular disease in the RACING trial. In European Heart Journal. Oxford University Press (OUP). https://doi.org/10.1093/eurheartj/ehac709