Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction:
Statins may not be utilized at a recommended intensity due to dose-dependent adverse events. Although ezetimibe is often added to a statin for primary prevention, few data on direct comparison of clinical outcomes between a low-intensity statin plus ezetimibe and a moderate-intensity statin is available.
Research Question or Hypothesis:
Is there any differences of efficacy and safety between a low-intensity statin plus ezetimibe and a moderate-intensity statin for primary prevention?
Study Design:
A population-based retrospective cohort study
Methods:
This study used the Korean nationwide claims database (2002–2019). We included adults without atherosclerotic cardiovascular diseases who received a moderate-intensity statin or a low-intensity statin plus ezetimibe. The primary outcome was a composite of all-cause mortality, myocardial infarction, and ischemic stroke. The safety outcomes were liver and muscle injuries and new-onset diabetes mellitus (DM). We used standardized inverse probability of treatment weighting (sIPTW) and propensity score matching (PSM).
Results:
In the sIPTW model, 1,717 and 36,683 patients used a low-intensity statin plus ezetimibe and a moderate-intensity statin, respectively. In the PSM model, each group included 1,687 patients. Compared to moderate-intensity statin use, low-intensity statin plus ezetimibe use showed similar risks of the primary outcome (hazard ratio (HR) 0.92, 95% confidence interval (CI) 0.81-1.12 in sIPTW and HR 1.16, 95% CI 0.87-1.56 in PSM model). Low-intensity statin plus ezetimibe use was associated with decreased risks of liver and muscle injuries (subHR (sHR) 0.84, 95% CI 0.74-0.96 and sHR 0.87, 95% CI 0.77-0.97 in sIPTW; sHR 0. 84, 95% CI 0.72-0.96 and sHR 0.82, 95% CI 0.72-0.94 in PSM model, respectively). For new-onset DM and hospitalization of liver and muscle injuries, no difference was observed.
Conclusion:
Low-intensity statin plus ezetimibe may be an alternative to moderate-intensity statin for primary prevention.
Presenting Author
Sukhyang Lee PharmD, PhDAjou University
Authors
Minji Jung PhD
University of California San Francisco
Jaekyu Shin Pharm.D.
University of California, San Francisco