Comparison of Efficacy and Safety of Statin–Ezetimibe Combination Therapy with Statin Monotherapy in Patients with Diabetes: A Meta-Analysis of Randomized Controlled Studies

2021 ◽  
Author(s):  
Kwang-Hee Shin ◽  
Hye Duck Choi
Keyword(s):  
Combination Therapy ◽  
Meta Analysis ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
Statin Monotherapy ◽  
Patients With Diabetes

scholarly journals The efficacy and safety of statin in combination with ezetimibe compared with double-dose statin in patients with high cardiovascular risk: A meta-analysis

2019 ◽  
Author(s):  
Yunyun Zhu ◽  
Haochang Hu ◽  
Jun Yang ◽  
Qi Yao ◽  
Hongyu Xu ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Combination Therapy ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Double Dose ◽  
Efficacy And Safety ◽  
High Cardiovascular Risk ◽  
Statin Monotherapy ◽  
Lipid Parameters

Currently, statins are the first-line therapies for dyslipidemia and atherosclerotic cardiovascular disease, however, their hypolipidemic effects have not been satisfactory. We performed a meta-analysis to compare lipid-lowering efficacy and safety of ezetimibe and statin combination therapy with double-dose statin monotherapy in patients with high cardiovascular risk. Fourteen studies involving 3,105 participants were included in the final analysis; 1,558 (50.18%) participants received ezetimibe and statin combination therapy and 1,547 (49.82%) received double-dose statin monotherapy. Eight studies reported the percentages of changes in several lipid parameters from baseline to endpoint in both groups. Lipid parameters changed more significantly in patients co-administered with ezetimibe and statin (low-density lipoprotein cholesterol [LDL-C]: MD = -9.39, 95% CI -13.36 to -5.42; non-high-density lipoprotein cholesterol [non-HDL-C]: MD = -10.36, 95% CI -14.23 to -6.50; total cholesterol [TC]: MD = -8.11, 95% CI -10.95 to -5.26; and triglyceride [TG]: MD = -5.96, 95% CI -9.12 to -2.80), with moderate to high heterogeneity among the studies. Two out of fourteen studies investigated several different statins. Our subgroup analysis showed that, compared with double-dose atorvastatin monotherapy, ezetimibe and atorvastatin combination therapy significantly decreased LDL-C, non-HDL-C, TC, and TG levels by 14.16%, 14.01%, 11.06%, and 5.96%, respectively (p < 0.001). No significant difference was found in the incidence of laboratory-related adverse events (AEs) between statin combination therapy and monotherapy. Overall, ezetimibe and statin combination therapy significantly decreased LDL-C, non-HDL-C, and TC levels in patients with high cardiovascular risk, among which ezetimibe combined with atorvastatin had the best therapeutic effect. Compared with ezetimibe and statin combination therapy, double-dose statin monotherapy did not increase the risk of AEs.

scholarly journals Comparison of Efficacy and Safety of Statin-ezetimibe Combination Therapy With Statin Monotherapy in Patients With Diabetes: A Meta-analysis of Randomised Controlled Studies

2021 ◽  
Author(s):  
Kwang-Hee Shin ◽  
Hye Duck Choi
Keyword(s):  
Combination Therapy ◽  
Adverse Events ◽  
Ldl Cholesterol ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
Apolipoprotein A1 ◽  
Published Data ◽  
Statin Monotherapy ◽  
Increased Risk ◽  
Patients With Diabetes

Abstract Background and aims: Diabetic dyslipidaemia is characterised by very high levels of triglycerides, low high-density lipoprotein (HDL), and slightly elevated low-density lipoprotein (LDL) cholesterol. Additionally, the potentially increased risk of morbidity and mortality following atherosclerotic cardiovascular diseases should be considered in the treatment of dyslipidaemia in patients with diabetes. Methods: We performed a meta-analysis of the published data to compare the effects of statin-ezetimibe combination therapy and statin monotherapy on lipid and glucose parameters in patients with diabetes. Additionally, the safety based on the reported adverse events was compared between the two groups. Results: Seventeen articles were included in this meta-analysis. In the efficacy assessment, the combination treatment afforded a significantly greater reduction in LDL cholesterol than did statin monotherapy (standard difference in means = 0.894; 95% confidence interval 0.598–1.191). A significantly greater improvement effect was observed in the levels of HDL cholesterol, total cholesterol, triglyceride, and apolipoprotein B, but not apolipoprotein A1, with combination therapy than with statin monotherapy. Additionally, combination therapy reduced the fasting blood glucose levels more significantly than did statin monotherapy. In terms of safety, there were no significant differences in treatment-related adverse events between the two treatments. Conclusions: Statin-ezetimibe combination therapy appears to enhance LDL cholesterol and other lipid levels without an increased risk of adverse events, compared with statin monotherapy. The present meta-analysis presents valid evidence for appropriate drug regimens to treat dyslipidaemia in patients with diabetes.

Efficacy and Safety of Ginkgo biloba in Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 48 (03) ◽  
pp. 513-534 ◽  
Author(s):  
Phui Zee Chong ◽  
Huey Ying Ng ◽  
Jing Tong Tai ◽  
Shaun Wen Huey Lee
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Ginkgo Biloba ◽  
Meta Analysis ◽  
Oral Formulation ◽  
Evaluation Methodology ◽  
Efficacy And Safety ◽  
Randomized Controlled ◽  
Randomized Controlled Studies ◽  
The Impact

Ginkgo biloba and its extract have been suggested to have a neuroprotective role in patients with acute ischemic stroke. We aimed to examine the efficacy and safety of Ginkgo biloba use in patients with acute ischemic stroke. We searched seven databases for randomized controlled studies examining the use of Ginkgo biloba in patients with acute ischemic stroke. Relevant studies were retrieved, screened, and data were extracted independently by two reviewers. Random effects meta-analyses were performed to evaluate the efficacy and safety outcomes of Ginkgo biloba. We subsequently assessed the certainty of evidence using the GRADE (Grading of Recommendation Assessment, Development and Evaluation) methodology. We found 12 randomized controlled studies enrolling 1466 patients. Pooled results suggest that Ginkgo biloba use was associated with an improvement in neurological function among individuals with AIS with a reduction of 2.87 points on the National Institute of Health Stroke Scale score (95% CI: [Formula: see text]–[Formula: see text], [Formula: see text]). Ginkgo biloba use was also associated with an improvement in activities of daily living and functional outcome (Mean Difference: 9.52; 4.66–14.33, [Formula: see text]). Subgroup analysis suggest that the impact was larger when using an injectable formulation of Ginkgo biloba compared to the oral formulation. There was no apparent impact of Ginkgo biloba use on all-cause mortality (Risk ratio (RR): 1.21; 0.29–5.09, [Formula: see text]) or cerebrovascular bleeding (RR: 0.82; 0.43–1.57, [Formula: see text]). There was limited evidence on to support the use of gingko biloba in terms of improving quality of life and other stroke events. As such, more studies are needed before it can be recommended for routine use in improving neurological and cognitive function in patients with acute ischemic stroke.

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