Ezetimibe for the Treatment of Uncontrolled Hypercholesterolemia in Patients with High‐Dose Statin Therapy After Renal Transplantation

• Published in: American journal of transplantation Vol. 6; no. 1; pp. 205 - 208
• Main Authors: Kohnle, M., Pietruck, F., Kribben, A., Philipp, Th, Heemann, U., Witzke, O.
• Format: Journal Article
• Language: English
• Published: Oxford UK Munksgaard International Publishers 01-01-2006; Blackwell
• Subjects: Adult; Aged; Anticholesteremic Agents - therapeutic use; Azetidines - adverse effects; Azetidines - therapeutic use; Biological and medical sciences; Cholesterol - blood; Cyclosporine - blood; Disorders of blood lipids. Hyperlipoproteinemia; Drug Therapy, Combination; Ezetimibe; Fatty Acids, Monounsaturated - therapeutic use; Female; Fluvastatin; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; hypercholesterolemia; Hypercholesterolemia - drug therapy; Indoles - therapeutic use; Kidney Transplantation; Liver - enzymology; Male; Medical sciences; Metabolic diseases; Middle Aged; Muscle, Skeletal - enzymology; Pravastatin - therapeutic use; renal transplantation; Simvastatin - therapeutic use; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tacrolimus - blood; Human; renal transplantation; Ezetimibe; Metabolic diseases; Lipids; Patient; Hyperlipoproteinemia; Statin derivative; Lipoprotein; Homotransplantation; Cholesterol; Kidney; Hypercholesterolemia; Treatment; Urinary system; Surgery; Graft; Dyslipemia; High dose; Antilipemic agent; Kidney transplantation
• ISSN: 1600-6135; 1600-6143
• DOI: 10.1111/j.1600-6143.2005.01132.x

We investigated prospectively the efficacy of ezetimibe in addition to statin therapy in stable renal transplant patients in whom hypercholesterolemia was not sufficiently treated. Eighteen renal transplant patients received 10 mg ezetimibe once daily in addition to high‐dose statin therapy for uncontrolled hypercholesterolemia. Total cholesterol, LDL‐cholesterol, HDL‐cholesterol, triglycerides, Tacrolimus (Tac)‐ and Cyclosporine A (CsA) blood levels, creatinine, urea, liver enzymes, electrolytes and creatinkinase (CK) were measured before initiation of ezetimibe therapy, after 7 days, 6 weeks and 3 months. Cholesterol concentrations decreased significantly (p < 0.005) from 264 ± 46 mg/dL at baseline to 205 ± 48 mg/dL after 1 week to 202 ± 48 mg/dL after 6 weeks and 212 ± 40 mg/dL after 3 months (reduction after 3 months 21 ± 10%). LDL‐concentrations decreased significantly (p < 0.005) from 178 ± 41 mg/dL at baseline to 129 ± 35 mg/dL after 1 week to 123 ± 25 after 6 weeks and to 117 ± 40 mg/dL after 3 months (reduction after 3 months 37 ± 14%). Two patients stopped ezetimibe therapy due to nausea and muscle pain without CK elevation. Significant changes of CsA and Tac blood levels, liver and muscle enzymes were not observed. Ezetimibe seems to be an effective therapy for uncontrolled hypercholesterolemia in renal transplant patients when combined with high‐dose statin therapy.