The review considers new efficacy and safety data that has been published since the first review in 2004. In particular the review considers the concerns raised linking ezetimibe with cancer that arose following publication of the SEAS Study.
The review notes that trials conducted with patient orientated clinical outcomes have so far failed to prove a benefit. It is therefore recommended that in patients with cardiovascular disease or in those at risk of developing it, "every effort should be made to reduce LDL-cholesterol with a statin alone". Additionally, use of the combination product (Inegy®) is discouraged based on the premium price for the single tablet.
Action: Clinicians should be aware of this review and National guidance for lipid modification. Ezetimibe is useful in cases of genuine statin intolerance or when treatment targets cannot be reached with optimal statin therapy.