Efficacy of ezetimibe for reducing serum low-density lipoprotein cholesterol levels resistant to lifestyle intervention in patients with non-alcoholic fatty liver disease

Aim To investigate the efficacy of ezetimibe and lifestyle intervention for treating patients with non-alcoholic fatty liver disease (NAFLD) and residual dyslipidemia via a combination of ezetimibe and lifestyle intervention. Methods Patients with NAFLD with residual dyslipidemia after a 6-month lifestyle intervention program were included. After completion of the 6-month program, the patients received p.o. administration of ezetimibe at 10 mg/day, in addition to lifestyle intervention, for 6 months. Results Of the 59 patients with NAFLD who had participated in the 6-month lifestyle intervention program between 2007 and 2012, 21 with residual dyslipidemia (10 males and 11 females) were enrolled. Median age was 58 years (range, 27–75), median bodyweight was 63.0 kg (range, 39.4–109.0), median body mass index was 25.4 kg/m2 (range, 18.2–37.1), median alanine aminotransferase was 23 IU/L (14–73), median high-density lipoprotein (HDL) was 58 mg/dL (range, 37–93), median triglycerides (TG) was 105 mg/dL (range, 42–216) and median low-density lipoprotein (LDL) was 153 (66–209) mg/dL. After 6 months of treatment with ezetimibe, serum LDL levels were improved in 15 of 20 (75%) patients (P = 0.0015), while no improvements were observed in the remaining five patient (25%). Ezetimibe was discontinued in one patient who developed skin rash. Conclusion Ezetimibe is effective for treating residual dyslipidemia after lifestyle intervention in patients with NAFLD.