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Response by Sex to Statin plus Ezetimibe or Statin Monotherapy: A Pooled Analysis from 22,231 Hyperlipidemic Patients.

Abstract : ABSTRACT: BACKGROUND: Despite documented benefits of lipid-lowering treatment in women, a considerable number are undertreated, and fewer achieve treatment targets vs. men. METHODS: Data were combined from 27 double-blind, active or placebo-controlled studies that randomized adult hypercholesterolemic patients to statin or statin+ezetimibe. Consistency of treatment effect among men (n=11,295) and women (n=10,499) was assessed and percent of men and women was calculated to evaluate the between-treatment ability to achieve specified treatment levels between sexes. RESULTS: Baseline lipids and hs-CRP were generally higher in women vs. men. Between-treatment differences were significant for both sexes (all p<0.001 except apolipoprotein A-I in men=0.0389). Men treated with ezetimibe+statin experienced significantly greater changes in LDL-C (p=0.0066), non-HDL-C, total cholesterol, triglycerides, HDL-C, apolipoprotein A-I (all p<0.0001) and apolipoprotein B (p=0.0055) compared with women treated with ezetimibe+statin. The odds of achieving LDL-C<100 mg/dL, apolipoprotein B<90 mg/dL and the dual target [LDL-C<100 mg/dL & apoliprotein B<90 mg/dL] was significantly greater for women vs. men and the odds of achieving hs-CRP<1 and <2 mg/L and dual specified levels of [LDL-C<100 mg/dL and hs-CRP<2 mg/L] were significantly greater for men vs. women. Women reported significantly more gall-bladder-related, gastrointestinal-related, and allergic reaction or rash-related adverse events (AEs) vs. men (no differences between treatments). Men reported significantly more CK elevations (no differences between treatments) and hepatitis-related AEs vs. women (significantly more with ezetimibe+simvastatin vs. statin). CONCLUSIONS: These results suggest that small sex-related differences may exist in response to lipid-lowering treatment and achievement of specified lipid and hs-CRP levels, which may have implications when managing hypercholesterolemia in women.
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Submitted on : Wednesday, September 28, 2011 - 1:06:09 AM
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Beth Abramson, Pascale Benlian, Mary Hanson, Jianxin Lin, Arvind Shah, et al.. Response by Sex to Statin plus Ezetimibe or Statin Monotherapy: A Pooled Analysis from 22,231 Hyperlipidemic Patients.. Lipids in Health and Disease, BioMed Central, 2011, 10 (1), pp.146. ⟨10.1186/1476-511X-10-146⟩. ⟨inserm-00627135⟩



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