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Elevated blood cholesterol levels are regarded as a risk factor for heart attacks and other cardiovascular diseases. However, this does notnecessarily mean that every cholesterol-lowering drug can alsoprevent heart attacks. For example, the benefit of thecholesterol-lowering drug ezetimibe is unclear. In particular,proof is lacking that patients have a greater benefit if they takeezetimibe in addition to statins for the prevention of heartattacks. This is the result of the final report published by theGerman Institute for Quality and Efficiency in Health Care (IQWiG)on 12 September 2011. Prescribed largely in combination with statins Ezetimibe is a cholesterol-absorption inhibitor. If taken orally,it acts in the small intestine by inhibiting the absorption ofcholesterol into the body from ingested food, which leads to areduction in blood cholesterol levels. It is hoped that this alsoreduces the risk of heart disease . Ezetimibe is currently prescribed mainly in combination with astatin, which is also used for the prevention of heart attacks incertain patients. For specific statins, various studies havedemonstrated that in such patients they not only lower cholesterollevels but may also prevent heart attacks and other cardiovascularcomplications. Patients with elevated cholesterol levels who do nottolerate these drugs can also take ezetimibe without a statin. IQWiG has now investigated whether ezetimibe - particularly incombination with statins - also lowers the risk of thecomplications mentioned. Benefit of combination therapy not proven A total of 2 studies were identified for the benefit assessment. Inboth studies, all patients received a statin as basic therapy. Inthe 24-month ENHANCE study, one half of the study participantsadditionally received ezetimibe, the others placebo. In the14-month ARBITER-6-HALTS study, ezetimibe was compared with niacin(nicotinic acid). Relevant studies investigating ezetimibe asmonotherapy were not available. IQWiG analysed the results of the ENHANCE and ARBITER-6-HALTSstudies particularly with regard to deaths, cardiovascularcomplications, health-related quality of life, and adverse effects.With regard to patient-relevant outcomes, neither of the 2 studiesshowed robust differences between the group of patients receivingezetimibe plus a statin and the control group. In summary, the data provide no indication that ezetimibe showsmore benefit or harm than niacin or placebo. However, the studiesavailable so far are too small and too short to conclusivelyclarify the benefit and harm of this drug. The attention of health care professionals is currently focused onan ongoing study (IMPROVE-IT). It is the first study with theprimary aim of comparing the effect of simvastatin plus ezetimibeversus simvastatin plus placebo on cardiovascular outcomes. Thestudy includes high-risk patients with acute coronary syndromewhose condition has already been stabilized. The results areexpected in 2013. Procedure of report production IQWiG published the preliminary results in the form of thepreliminary report at the beginning of May 2011 and interestedparties were invited to submit comments. When the comments stageended, the preliminary report was revised and sent as a finalreport to the contracting agency, the Federal Joint Committee, inJuly 2011. Only one written comment was received, which waspublished in a separate document at the same time as the finalreport. The report was produced in collaboration with externalexperts. An overview of the background, methods and further results of thefinal report is provided in the executive summary.* Additional References Citations. We are high quality suppliers, our products such as Yag Laser Hair Removal Machine , China Ultrasonic Cavitation Slimming Machine for oversee buyer. To know more, please visits Yag Laser Hair Removal Machine.
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