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GRAVITY: Rosuvastatin plus ezetimibe showed greatest reductions in lipid parameters
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American College of Cardiology 59th Annual Scientific Sessions
ATLANTA – Patients assigned to combination therapy with rosuvastatin plus ezetimibe experienced greater reductions in LDL, non-HDL and apolipoprotein B when compared with patients assigned to simvastatin plus ezetimibe, new data from the GRAVITY trial suggested.
Researchers conducted the open-label, randomized study of patients with coronary heart disease and elevated LDL (130 mg/dL to 220 mg/dL) and triglyceride (<400 mg/dL) levels. They assessed the safety and efficacy of four treatment combinations:
- rosuvastatin 10 mg (Crestor, AstraZeneca) plus ezetimibe 10 mg (Zetia, Merck/Schering-Plough) (n=210);
- rosuvastatin 20 mg plus ezetimibe 10 mg (n=204);
- simvastatin 40 mg (Zocor, Merck/Schering-Plough) plus ezetimibe 10 mg (n=199); or
- simvastatin 80 mg plus ezetimibe 10 mg (n=210).
All patients were also assigned to a six-week dietary lead-in and washout of therapies followed by rosuvastatin 10 mg, rosuvastatin 20 mg, simvastatin 40 mg or simvastatin 80 mg alone for six weeks, and then the addition of ezetimibe 10 mg for six more weeks.
From baseline to week 12, rosuvastatin 20 mg plus ezetimibe 10 mg produced the greatest decrease in LDL levels — more patients achieved LDL <100 mg/dL when compared with simvastatin 40 mg plus ezetimibe 10 mg.
Further, a greater number of patients assigned to rosuvastatin 20 mg plus ezetimibe 10 mg achieved LDL goals <100 mg/dL and <70 mg/dL compared with those assigned simvastatin 40 mg plus ezetimibe 10 mg or simvastatin 80 mg plus ezetimibe 10 mg.
Combination rosuvastatin plus ezetimibe was also associated with significant reductions in LDL, non-HDL, triglycerides and apolipoprotein B.
“Rosuvastatin plus ezetimibe is a good option to get patients’ targets at around 95%,” Christie M. Ballantyne, MD, associate chief and clinical director of the section of atherosclerosis, department of medicine, at Baylor College of Medicine in Houston, told Cardiology Today. “Statins are the first option, but this is another option.”
Ballantyne added that all treatments were safe and well tolerated; however, one case of myopathy was reported with simvastatin 80 mg alone. – by Jennifer Southall
For more information:
- Ballantyne CM. Poster #1019-98. Presented at: American College of Cardiology 59th Annual Scientific Sessions; March 13-16, 2010; Atlanta.
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