Ezetimibe-associated myopathy in monotherapy and in combination with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor

Simard, Chantale; Poirier, Paul

doi:10.1016/s0828-282x(06)70253-7

Cited by 46 publications

(39 citation statements)

References 21 publications

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“…The recognition that cholesterol-lowering agents cause myopathy goes back decades to the era when fibric acid derivatives and bile-acid sequestering drugs were the most commonly used agents [2,3]. The problem of myotoxicity continued when statins were introduced and continues to occur even now with the newest agents, such as ezetimibe, which has been reported to cause myopathy when used as monotherapy or with a statin [4,5,6•] (although some dispute this view [7]). …”

Section: Introductionmentioning

confidence: 99%

Statin myopathy

Radcliffe

Campbell²

2008

Curr Neurol Neurosci Rep

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Many different classes of medications can cause toxic myopathy. One of the most frequently implicated classes is the statins. Statin myotoxicity ranges from asymptomatic creatine kinase elevations or myalgias to muscle necrosis and fatal rhabdomyolysis. Statins may also cause an autoimmune myopathy requiring immunosuppressive treatment. The mechanisms of statin myotoxicity are unclear. If unrecognized in its early manifestations, complications from continued statin therapy may lead to rhabdomyolysis and death. Risk factors for myotoxicity include concomitant medication use and medical conditions, and the patient's underlying genetic constitution. We review these considerations along with the recommended evaluation and treatment for patients presenting with statin myotoxicity.

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Section: Introductionmentioning

confidence: 99%

Statin myopathy

Radcliffe

Campbell²

2008

Curr Neurol Neurosci Rep

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“…Rhabdomyolysis has not been described, however. More recent reports also emphasize the occurrence of myopathy following the use of ezetimibe in patients with preexistent muscle disease including McArdle myopathy 5,6 . Several mechanisms of action have been proposed to explain this phenomenon, including the connection between metabolic and inflammatory disorders, but no clear pathogenic mechanism has been identified to date 7 .…”

Section: Ezetimibe-induced Relapsing Polymyositismentioning

confidence: 99%

“…Much less recognized, however, is the development of muscle involvement following the use of ezetimibe, another lipid-lowering agent introduced recently [1][2][3][4][5] . We describe a patient with polymyositis (PM) in remission who relapsed after starting therapy with this newer lipid-lowering medication.…”

Section: Ezetimibe-induced Relapsing Polymyositismentioning

confidence: 99%

Ezetimibe-induced Relapsing Polymyositis: Table 1

García-Valladares¹,

Espinoza²

2010

J Rheumatol

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“…Despite some isolated reports of myopathy attributable to ezetimibe [73], the adverse event profile in several large trials was similar to that of placebo [74]. Studies assessing specifically the short-term safety of the atorvastatinezetimibe combination showed similar results, with no significant differences in the incidences of laboratory and clinical adverse events, including gastrointestinal, liver, or muscle effects [46][47][48][49][50].…”

Section: Safety Of the Ezetimibe-atorvastatin Combinationmentioning

confidence: 99%

Defining the Place of Ezetimibe/Atorvastatin in the Management of Hyperlipidemia

Ferreira

Silva

2016

Am J Cardiovasc Drugs

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Statin-ezetimibe combinations are a potentially advantageous therapeutic option for high-risk patients who need additional lowering of low-density lipoprotein cholesterol (LDL-C). These combinations may overcome some of the limitations of statin monotherapy by blocking both sources of cholesterol. Recently, a fixed-dose combination with atorvastatin, one of the most extensively studied statins, was approved and launched in several countries, including the USA. Depending on atorvastatin dose, this combination provides LDL-C reductions of 50-60%, triglyceride reductions of 30-40%, and highdensity lipoprotein cholesterol (HDL-C) increases of 5-9%. Studies comparing the lipid-lowering efficacy of the atorvastatin-ezetimibe combination with the alternatives of statin dose titration or switching to a more potent statin consistently showed that combination therapy provided greater LDL-C reduction, translating into a greater proportion of patients achieving lipid goals. Simvastatinezetimibe combinations have been shown to reduce the incidence of major atherosclerotic events in several clinical settings to a magnitude that seems similar to that observed with statins for the same degree of absolute LDL-C lowering. The atorvastatin-ezetimibe combination has also been shown to induce the regression of coronary atherosclerosis measured by intravascular ultrasound in a significantly greater proportion of patients than atorvastatin alone. Atorvastatin-ezetimibe combinations are generally well tolerated. Previous concerns of a possible increase in the incidence of cancer with ezetimibe were dismissed in large trials with long follow-up periods. In this paper, we examine the rationale for an atorvastatin-ezetimibe combination, review the evidence supporting it, and discuss its potential role in the management of dyslipidemia. Key PointsStatin-ezetimibe combinations are a realistic treatment option for patients who do not achieve low-density lipoprotein cholesterol (LDL-C) targets while receiving statin monotherapy and for patients prone to dose-dependent statin side effects.The IMPROVE-IT trial was the first to demonstrate a reduction in cardiovascular events with ezetimibe.Recently, combination therapy with atorvastatin plus ezetimibe was also associated with greater coronary plaque regression than atorvastatin alone.

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Ezetimibe-associated myopathy in monotherapy and in combination with a 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor

Cited by 46 publications

References 21 publications

Statin myopathy

Statin myopathy

Ezetimibe-induced Relapsing Polymyositis: Table 1

Defining the Place of Ezetimibe/Atorvastatin in the Management of Hyperlipidemia

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