Ezetimibe

Ezetimibe is a cholesterol absorption inhibitor commonly used alone (Zetia) or along with simvastatin in a combined therapy (Vytorin) for cholesterol management. It prevents the absorption of dietary LDL from the intestine. Ezetimibe has been used singly and in combination with statin therapy for the treatment of elevated LDL levels. Further beneficial effects have been reported, notably, raising HDL and lowering triglycerides, non-HDL-cholesterol, apolipoprotein B and remnant-like particle cholesterol, reduction in circulating phytosterols and oxysterols and, when used in combination with statins, a reduction in high-sensitivity C-reactive protein⁴². However, in a recent study in patients with familial hypercholesteremia, combined therapy with ezetimibe and simvastatin did not result in a significant difference in changes in intima–media thickness compared with simvastatin alone, despite decreases in levels of LDL cholesterol and C-reactive protein⁴³.