Biochemical Efficacy and Clinical Benefit of Dual Inhibition of Cholesterol Using Ezetimibe and Simvastatin

Despite the prognostic importance of achieving target cholesterol levels, the majority of patients with hypercholesterolemia do not achieve them. Statins remain the drugs of choice for the treatment of hypercholesterolemia due to their efficacy and their beneficial effects on morbidity and mortality. Nevertheless, there is a progressive loss of efficacy at high doses, which makes it difficult to achieve target levels in high-risk patients. Ezetimibe is a selective cholesterol absorption inhibitor that has been shown to be effective and well tolerated in clinical trials in which the drug was given in combination with various statins. Its use enabled therapeutic targets to be achieved in a large number of patients. In addition, there is also evidence that ezetimibe is effective in patients with renal failure. This article reviews the efficacy and clinical benefits of ezetimibe and considers questions raised about the drug’s possible effects on morbidity and mortality.