Effectiveness and safety of atorvastatin/ ezetimibe fixed-dose combination in hypercholesterolemia: a systematic review and network meta-analysis.

What was studied

This review compared atorvastatin alone with atorvastatin plus ezetimibe. It compared a fixed-dose pill with a free-equivalent combination. People had high cholesterol. The review pooled randomized trials in a network analysis. It covered 10,567 people. The main outcomes were change in LDL-C and reaching an LDL-C goal. It also compared safety and tolerability.

What they found

Both combinations lowered LDL-C more than atorvastatin alone. The fixed-dose pill ranked highest for lowering LDL-C. The free-equivalent combination ranked next. Atorvastatin alone ranked last. For reaching the LDL-C goal, the risk ratio was 1.87 for the free-equivalent combination. It was 1.80 for the fixed-dose pill. The range for the pill was wide, 0.85 to 3.81. Safety did not differ significantly between treatments.

What it means for patients

The authors say the combinations lowered LDL-C more than atorvastatin alone. They say more people reached the goal. They say the combinations did not raise adverse events. They say the findings support the fixed-dose pill when intensive LDL-C lowering is needed.

Why it is not certain yet

The goal attainment result for the fixed-dose pill had a wide range. The abstract does not give the length of the trials. It does not report heart events. A network analysis compares treatments across trials.

Source

Effectiveness and safety of atorvastatin/ ezetimibe fixed-dose combination in hypercholesterolemia: a systematic review and network meta-analysis.

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