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Effects and Safety of Statin and Ezetimibe Combination Therapy in Patients with Chronic Kidney Disease: A Systematic Review and Meta-Analysis.

Authors
  • Lin, Yi-Chih1, 2, 3
  • Lai, Tai-Shuan3
  • Wu, Hon-Yen1, 3, 4, 5
  • Chou, Yu-Hsiang2, 3, 6
  • Chiang, Wen-Chih3
  • Lin, Shuei-Liong3, 6, 7, 8
  • Chen, Yung-Ming3
  • Chu, Tzong-Shinn3
  • Tu, Yu-Kang1, 9, 10
  • 1 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. , (Taiwan)
  • 2 Department of Medicine, National Taiwan University Hospital Jinshan branch, New Taipei City, Taiwan. , (Taiwan)
  • 3 Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan. , (Taiwan)
  • 4 Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan. , (Taiwan)
  • 5 Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. , (Taiwan)
  • 6 Graduate Institute of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan. , (Taiwan)
  • 7 Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan. , (Taiwan)
  • 8 Research Center for Developmental Biology and Regenerative Medicine, National Taiwan University, Taipei, Taiwan. , (Taiwan)
  • 9 Department of Dentistry and Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan. , (Taiwan)
  • 10 Research center of big data and meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. , (Taiwan)
Type
Published Article
Journal
Clinical Pharmacology & Therapeutics
Publisher
Wiley (Blackwell Publishing)
Publication Date
Oct 01, 2020
Volume
108
Issue
4
Pages
833–843
Identifiers
DOI: 10.1002/cpt.1859
PMID: 32320058
Source
Medline
Language
English
License
Unknown

Abstract

The efficacy and safety of statin and ezetimibe combination therapy in patients with chronic kidney disease (CKD) remains unclear. To assess the effect of statin and ezetimibe combination therapy on controlling lipid profiles and reducing cardiovascular events in patients with CKD, we conducted a systematic review and meta-analysis. We selected randomized controlled trials comparing this combination therapy with statin monotherapy or placebo in patients with CKD from the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases published before September 1, 2018 on the Internet. Eight articles on seven studies, with a total of 14,016 patients with CKD, were selected from 412 full-text articles. Statin and ezetimibe combination therapy had beneficial effects on serum total cholesterol (weighted mean difference (WMD) -20.31 mg/dL, 95% confidence interval (CI), -26.87 to -13.75 mg/dL, P < 0.001), low-density lipoprotein cholesterol (WMD -17.22 mg/dL, 95% CI, -18.93 to -15.51 mg/dL, P < 0.001), and triglycerides (WMD -15.08 mg/dL, 95% CI, -23.41 to -6.75 mg/dL, P < 0.001) compared with statin monotherapy. Statin and ezetimibe combination therapy significantly reduced all-cause mortality and major adverse cardiovascular events (risk ratio 0.86, 95% CI, 0.77 to 0.97, P = 0.01). The incidence of adverse events was low, with no significant difference between statin and ezetimibe combination therapy and statin monotherapy. In conclusion, the statin and ezetimibe combination therapy significantly improved serum lipid profiles and reduced risks of all-cause deaths and major adverse cardiovascular events compared with the control group in patients with CKD. © 2020 The Authors Clinical Pharmacology & Therapeutics © 2020 American Society for Clinical Pharmacology and Therapeutics.

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