Is Deprescription of Ezetimibe Safe in Familial Hypercholesterolemia Patients Taking Evolocumab?

Abstract

We evaluated whether low-density lipoprotein cholesterol (LDL-C) levels in familial hypercholesterolemia patients on triple lipid-lowering therapy would remain below intensification threshold values after withdrawal of ezetimibe. We included 13 heterozygous familial hypercholesterolemia patients with vascular disease who were treated with statin + ezetimibe + evolocumab; ezetimibe was discontinued at the patients' request. After 3 months, LDL-C levels increased from 0.96 ± 0.51 to 1.54 ± 1.07 mmol/L. In 12 of 13 patients, the LDL-C level remained below 1.8 mmol/L. No adverse cardiovascular events were observed. Deprescribing ezetimibe reduced pill burden but increased LDL-C level, although usually not above the treatment intensification threshold for high-risk patients.

• Authors: Shyann Hang, Julieta Lazarte, Robert A Hegele
• Journal: CJC open (CJC Open) Vol. 4 Issue 4 Pg. 428-431 (Apr 2022) ISSN: 2589-790X [Electronic] United States
• PMID: 35495867 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors.