Evidence map›Paper›PMID 23040830›Full record

Trial reportAtherosclerosis2012

Effects of ezetimibe added to statin therapy on markers of cholesterol absorption and synthesis and LDL-C lowering in hyperlipidemic patients.

Nuntakorn Thongtang, Jianxin Lin, Ernst J Schaefer, Robert S Lowe, Joanne E Tomassini, Arvind K Shah, Andrew M Tershakovec

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Atherosclerosis, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events.The Cochrane database of systematic reviews · 2018 · on this map
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Nuntakorn ThongtangLipid Metabolism Laboratory, Human Nutrition Research Center on Aging at Tufts University, 711 Washington Street, Boston, MA 02111, USA. nuntakorn.thongtang@tufts.edu
Jianxin Lin
Ernst J Schaefer
Robert S Lowe
Joanne E Tomassini
Arvind K Shah
Andrew M Tershakovec
Merck & Co., Inc., Rahway, NJ, USA (United States) · USSiriraj Hospital · THTufts University · US

Funding

Weight Loss, Inflammation, and Vascular RemodelingP50HL083813 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI WELTY, FRANCINE K · 2006 to 2015
$13.0M
Pharmacogenetics of the Statin ResponseR01HL074753 · NHLBI · TUFTS UNIVERSITY BOSTON · PI SCHAEFER, ERNST JOHN · 2003 to 2006
$3.1M
MOLECULAR BASIS OF HIGH DENSITY LIPOPROTEIN DEFICIENCYR01HL060935 · NHLBI · TUFTS UNIVERSITY BOSTON · PI SCHAEFER, ERNST JOHN · 1999 to 2009
$2.2M
NHLBI NIH HHS HL 74753NHLBI NIH HHS P050HL083813NHLBI NIH HHS P50 HL083813NHLBI NIH HHS R01 HL060935NHLBI NIH HHS R01 HL074753NHLBI NIH HHS R01 HL-60935
6 · The paper itself

Abstract

objectiveStatins inhibit cholesterol synthesis but can upregulate cholesterol absorption, with higher doses producing larger effects. Ezetimibe inhibits cholesterol absorption but also upregulates synthesis. We tested whether ezetimibe added to on-going statin therapy would be most effective in lowering LDL-cholesterol (LDL-C) in subjects on high-potency statins and whether these effects would be related to alterations in cholesterol absorption (β-sitosterol) and synthesis (lathosterol) markers.

methodsHypercholesterolemic subjects (n = 874) on statins received ezetimibe 10 mg/day. Plasma lipids, lathosterol, and β-sitosterol were measured at baseline and on treatment. Subjects were divided into low- (n = 133), medium- (n = 582), and high- (n = 159) statin potency groups defined by predicted LDL-C-lowering effects of each ongoing statin type and dose (reductions of ~20-30%, ~31-45%, or ~46-55%, respectively).

resultsThe high-potency group had significantly lower baseline lathosterol (1.93 vs. 2.58 vs. 3.17 μmol/l; p < 0.001) and higher baseline β-sitosterol values (6.21 vs. 4.58 vs. 4.51 μmol/l, p < 0.001) than medium-/low-potency groups. Ezetimibe treatment in the high-potency group produced significantly greater reductions from baseline in LDL-C than medium-/low-potency groups (-29.1% vs. -25.0% vs. -22.7%; p < 0.001) when evaluating unadjusted data. These effects and group differences were significantly (p < 0.05) related to greater β-sitosterol reductions and smaller lathosterol increases. However, LDL-C reduction differences between groups were no longer significant after controlling for placebo effects, due mainly to modest LDL-C lowering by placebo in the high-potency group.

conclusionPatients on high-potency statins have the lowest levels of cholesterol synthesis markers and the highest levels of cholesterol absorption markers at baseline, and the greatest reduction in absorption markers and the smallest increases in synthesis markers with ezetimibe addition. Therefore, such patients may be good candidates for ezetimibe therapy if additional LDL-C lowering is needed.

Indexed as

AgedAnticholesteremic AgentsApolipoproteinsAzetidinesBiomarkersCholesterolCholesterol, LDLC-Reactive ProteinDouble-Blind MethodDrug Therapy, CombinationEzetimibeFemaleHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaIntestinal AbsorptionAnticholesteremic AgentsApolipoproteinsAzetidinesBiomarkersCholesterolCholesterol, LDLC-Reactive ProteinEzetimibegamma-sitosterolHydroxymethylglutaryl-CoA Reductase InhibitorslathosterolSitosterols

Identifiers

PMID23040830
PMCPMC3749834
OpenAlexW2080241928

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.