HealthDay News— For patients with hypercholesterolemia, simvastatin is superior to ezetimibe for producing lymphocyte-suppression and systemic anti-inflammatory and endothelial protective effects, according to a study published in the January issue of the Journal of Internal Medicine.
Robert Krysiak, MD, PhD, from the Medical University of Silesia in Poland, and colleagues compared the effects of ezetimibe and simvastatin, administered alone or in combination, on the secretory function of human lymphocytes, systemic inflammation, and endothelial function. One hundred and seventy ambulatory patients with isolated hypercholesterolemia were randomly assigned to 90 days of treatment with ezetimibe, simvastatin, ezetimibe plus simvastatin, or placebo. Lymphocyte cytokine release and plasma levels of high-sensitivity C-reactive protein (hsCRP) and intercellular adhesion molecule 1 (ICAM-1) were the main outcomes measured.
The investigators found that both simvastatin and ezetimibe decreased the lymphocyte release of tumor necrosis factor-α, interferon-γ, and interleukin-2 in a lipid-independent manner. For simvastatin, but not ezetimibe, the effect was statistically significant. Patients receiving both simvastatin and ezetimibe showed the strongest lymphocyte-suppressing effect, which was accompanied by a significant reduction in plasma hsCRP and ICAM-1 levels. The effect of simvastatin on lymphocyte-suppression, systemic inflammation, and endothelial protection did not differ between insulin-resistant and insulin-sensitive participants. However, insulin-resistant patients showed significantly greater effects of ezetimibe and combined treatment on lymphocyte-suppression, systemic inflammation, and endothelial protection.
“Hypercholesterolemic patients with high cardiovascular risk may receive the greatest benefits from concomitant treatment with a statin and ezetimibe,” the authors write.