Let’s review the results of a study in which investigators compared the efficacy of adding ZETIA to patients taking atorvastatin 10 mg daily vs response-based titration of atorvastatin monotherapy.

After 4 weeks of treatment, patients titrated to atorvastatin 20 mg experienced an incremental 9% reduction in LDL-C, whereas patients treated with ZETIA added to the atorvastatin 10 mg dose experienced an incremental 23% reduction in LDL-C. Relative to the LDL-C reduction on the starting dose of atorvastatin 10 mg, the incremental reduction achieved by adding ZETIA to atorvastatin was more than 2.5 times the incremental reduction achieved by titrating atorvastatin 10 mg to 20 mg. Thus, the addition of ZETIA to atorvastatin 10 mg provided superior LDL-C reduction compared with titration of atorvastatin from 10 to 20 mg.

Eligibility in this 14-week, multicenter, randomized, double-blind, active-controlled study was limited to high-risk patients with hypercholesterolemia and CHD, at least 2 cardiovascular risk factors, or with heterozygous familial hypercholesterolemia and an LDL-C level that was greater than or equal to 130 mg/dL despite currently being treated with atorvastatin 10 mg.

ZETIA, administered alone or in combination with an HMG-CoA reductase inhibitor (statin), is indicated as adjunctive therapy to diet for the reduction of elevated TOTAL-C, LDL-C, and Apo B in patients with primary (heterozygous familial and nonfamilial) hypercholesterolemia when diet alone is not enough.

Contraindications include hypersensitivity to any component of this medication. Contraindications when used with a statin include active liver disease; unexplained persistent elevations of serum transaminases. Statins are contraindicated in pregnant and nursing women; refer to the statin label for details.