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Efficacy of Ezetimibe as Monotherapy in Hypercholesterolemic Patients with and without Diabetes: A Randomized Controlled Clinical Trial

Background: Hyperlipidemia, hypertension, and diabetes are common diseases in the elderly. They are the main factor of cardiovascular disease and thus increase the risk of mortality. Recently, the death rate caused by COVID-19 is not predictable but has been increased by many factors, including age, hyperlipidemia, diabetes mellitus, obesity, and cardiovascular disorders. Objective: Since many patients with these conditions are under lipid-lowering therapy, we carried out this study to evaluate the effect of ezetimibe on hyperlipidemia in patients with type 2 diabetes mellitus, non-diabetic, and COVID19. Patients and methods: In this study, 13 hypercholesterolemic patients were categorized per disease suffering from (Diabetes, non-diabetic and COVID-19). All patients were administered 10 mg of ezetimibe each day for 90 days. Afterward, their lipid profile was measured at baseline and then after 30, 60, and 90 days. Plasma total cholesterol (TC), triglycerides (TG), low-density lipoprotein (LDL)-cholesterol, high-density lipoprotein (HDL), and very-low-density lipoprotein (VLDL) were measured. Results: HDL increased in diabetic and hypertensive patients by 24% and 6.2 % but decreased in the COVID patients by 1.29 %, in response to ezetimibe. Total Cholesterol and LDL decreased by 39.64 %, 30.32 % & 58.58% and 38.4 %, 25.33%, & 54.93 %, respectively. Results showed a considerable increase in triglyceride concentration by 13.5% and 23 % at 30 and 90 days of treatment in COVID-19 patients. Conclusion: These findings reveal that ezetimibe was an effective treatment of hyperlipidemia among diabetic patients. In addition Sars-CoV-2 might be a factor interacting with hyperlipidemia-reducing therapy and lower ezetimibe efficacy. However, larger cohort studies are required to confirm these findings.