Abstract 3729: Enhanced Attainment of Optional Recommended Levels of LDL-C, Apolipoprotein B, non-HDL and hsCRP in Type 2 Diabetes Patients Treated with Ezetimibe/simvastatin Compared to Atorvastatin
Background: Patients with type 2 diabetes (T2DM) are at risk for cardiovascular disease (CVD). In addition to LDL-C, non-HDL, apolipoprotein (Apo B) and C reactive protein (hsCRP) are considered to be predictive risk factors for CVD. This study assessed the proportion of T2DM patients treated with Ezetimibe/simvastatin (E/S) versus Atorvastatin (A) who attained the optional target for LDL-C (<70 mg/dL) and additionally one of the following: Apo B <90 mg/dL, hs-CRP <2 mg/L and among patients with triglycerides (TG) ≥ 200 mg/dL, non-HDL-C <100 mg/L.
Methods: A post-hoc analysis based on efficacy data obtained from a multicenter, randomized, double-blind, 6 week parallel study in which the usual and alternate starting doses of E/S (10/20 and 10/40 mg) and A (10, 20 and 40 mg) were compared in T2DM patients with hypercholesterolemia (HC). The proportion of patients who attained optional target levels was assessed by logistic regression analysis.
Results: Baseline characteristics were comparable among treatment groups. A significantly higher percentage of patients treated with E/S compared to A attained the optional recommended levels of LDL-C and Apo B, LDL-C and non-HDL-C, and LDL-C and hs-CRP at all dose comparisons (see table⇓). Similarly, a greater percentage of patients treated with E/S versus A achieved single target levels for LDL-C, Apo B and non-HDL. At E/S 10/20 mg, the percentage of patients who achieved hsCRP <2 mg/L was also higher than with A10 or 20 mg, and at E/S 40 mg and A 40 mg, the % attainment of hsCRP <2 mg/L was comparable.
Conclusion: Significantly higher percentages of patients attained the optional recommended levels of LDL-C and targets set for Apo B, non-HDL-C, and hsCRP with E/S compared to A among T2DM patients with HC. Thus, the dual cholesterol-lowering mechanism of E/S provides a therapeutic option to T2DM patients for reaching treatment goals in the reduction of CVD risk.