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Ezetimibe: New perspectives in lipid lowering treatment.

Therapeutic goals for lipid lowering treatment in the prevention of ischemic heart disease are often not reached in clinical practice. Even the highest doses of statins do not guarantee good control of hypercholesterolemia in all patients. Therefore, new lipid lowering drugs are being investigated. One of them is ezetimibe - intestinal cholesterol absorption inhibitor. Treatment with ezetimibe results in significant reduction of total cholesterol and LDL cholesterol levels. It is hoped that concomitant treatment with ezetimibe and other lipid lowering drugs (particularly statins) will be more effective. In large randomized clinical trials, co-administration of ezetimibe with atorvastatin and simvastatin proved to be more effective in lowering cholesterol levels and reaching target therapeutic levels than treatment with statin alone. In addition, combined treatment with ezetimibe and simvastatin was more effective compared to treatment with today's most effectively used statin (rosuvastatin) alone. Reduction of statin dose, due to the combined treatment with ezetimibe, lowers the risk of adverse events. Results of the published studies suggest that ezetimibe is safe and when administered together with statin does not increase the risk of liver or muscle damage. Treatment with ezetimibe may be regarded as a new option in the management of patients who need lipid lowering treatment. (Cardiol J 2007; 14: 232-237).