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Research Article
The comparative efficacy of ezetimibe added to atorvastatin 10 mg versus uptitration to atorvastatin 40 mg in subgroups of patients aged 65 to 74 years or greater than or equal to 75 years
Ori Ben-Yehuda,Nanette K. Wenge,Christian Constance,Franklin Zieve,Mary E. Hanson,Jian-Xin Lin,Arvind K. Shah,Charlotte Jones-Burton,Andrew M. Tershakovec.J Geriatr Cardiol 2011,8(1):1~11
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Authors:Ori Ben-Yehuda1;Nanette K. Wenge2;Christian Constance3;Franklin Zieve4;Mary E. Hanson5;Jian-Xin Lin5;Arvind K. Shah5;Charlotte Jones-Burton5;Andrew M. Tershakovec5

Author Affiliation:1.University of California San Diego, 200 West Arbor Drive, La Jolla, CA 92103, USA;2.Emory University School of Medicine, 49 Jess Hill Jr Dr SE, Atlanta, GA 30303, USA;3.Hopital Maisonneuve-Rosemont Recherche Clinique/Polyclinique, 5415 Boulevard de l'Assomption, Suite 295, Montreal Quebec, QC H1T 2M4, Canada;4.McGuire VA Medical Center, 1201 Broad Rock Blvd (151), Richmond, VA 23249, USA;5.Merck-Sharp & Dohme, One Merck Drive, Whitehouse Station, NJ 08889, USA;


Abstract: Background Coronary heart disease (CHD) risk increases with age; yet lipid-lowering therapies are significantly under-utilized in patients > 65 years. The objective was to evaluate the safety and efficacy of lipid-lowering therapies in older patients treated with atorvastatin 10 mg + ezetimibe 10 mg (EZ/Atorva) vs. increasing the atorvastatin dose to 40 mg. Methods Patients ≥ 65 years with atherosclerotic vascular disease (LDL-C ≥ 1.81 mmol/L) or at high risk for coronary heart disease (LDL-C ≥ 2.59 mmol/L) were randomized to EZ/Atorva for 12 wk vs. uptitration to atorvastatin 20 mg for 6 wk followed by atorvastatin 40 mg for 6 wk. The percent change in LDL-C and other lipid parameters and percent patients achieving prespecified LDL-C levels were assessed after 12 wk. Results EZ/Atorva produced greater reductions in most lipid parameters vs. uptitration of atorvastatin in patients ≥ 75 years (n = 228), generally consistent with patients 65–74 years (n = 812). More patients achieved LDL-C targets with combination therapy vs. monotherapy in both age groups at 6 wk and in patients ≥ 75 years at 12 wk. At 12 wk, more patients ≥ 75 years achieved LDL-C targets with monotherapy vs. combination therapy. EZ/Atorva produced more favorable improvements in most lipids vs. doubling or quadrupling the atorvastatin dose in patients ≥ 75 years, generally consistent with the findings in patients 65–74 years. Conclusions Our results extended previous findings demonstrating that ezetimibe added to a statin provided a generally well-tolerated therapeutic option for improving the lipid profile in patients 65 to 74 years and ≥ 75 years of age.


cholesterol absorption inhibitor; LDL-C; hypercholesterolemia; statin
Received:February 10, 2011           Published Online:March 28, 2011
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