Effects of ezetimibe/simvastatin vs. rosuvastatin on lowering of LDL-cholesterol as well as Apo-lipoprotein B, non-HDL-cholesterol, or C-reactive protein

Background: In addition to LDL-C, a growing body of evidence suggests that ApoB, non-HDL-C and CRP are predictive of CHD risk. This post-hoc analysis evaluates the % of patients who attained LDL-C<70mg/dL and specific levels of these other or emerging risk factors. Methods: This was a double-blind, 6-week, parallel group trial of hypercholesterolemic patients randomized to ezetimibe/simvastatin (E/S:10/20, 10/40, 10/80mg) or rosuvastatin (R:10, 20, 40mg), treatment comparisons between usual starting, next highest, maximum doses, and averaged across doses. Results: Baseline characteristics were similar among groups. At most dose comparisons, a significantly higher % of patients receiving E/S vs. R achieved LDL-C<70 mg/dL and the specified levels of the other or emerging risk factors, both individually and in combination with the LDL-C goal. Exceptions were no significant treatment differences for ApoB<90mg/dL and (non-HDL-C<100mg/dL + LDL-C<70mg/dL) when comparing E/S 10/40mg vs. R 20mg, and none for CRP<2.0mg/L at all dose comparisons. See table for comparison of combined dose groups. Conclusion: The potentially greater efficacy of E/S compared with R extends to modifications of some other and emerging risk factors. Ultimate clinical implications of these findings still need to be defined