# Matige statine plus ezetimibe versus hoge-dosis statine bij diabetes en ASCVD

*geplaatst 2023-03-14 · Preventie · European heart journal · doi 10.1093/eurheartj/ehac709 · https://hartvaat.nl/2023/03/14/matige-statine-plus-ezetimibe-versus-hoge-dosis-statine-bij-diabetes-en-ascvd/*

Subanalyse bij diabetespatiënten met ASCVD bevestigde dat matige statine met ezetimibe non-inferieur was aan hoge-dosis statine voor CV-uitkomsten. Het gunstigere bijwerkingenprofiel kan de therapietrouw bij diabetespatiënten verbeteren.

## English: Moderate-intensity statin with ezetimibe vs. high-intensity statin in patients with diabetes and atherosclerotic cardiovascular disease in the RACING trial.

This subanalysis in diabetic patients with ASCVD confirmed that moderate-intensity statin plus ezetimibe is noninferior to high-intensity statin monotherapy for cardiovascular outcomes, supporting combination therapy as an alternative in diabetes.

## Abstract (original, from the publication)

AIMS: This study evaluated the effect of moderate-intensity statin with ezetimibe combination therapy vs. high-intensity statin monotherapy among patients with diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD). METHODS AND RESULTS: This was a pre-specified, stratified subgroup analysis of the DM cohort in the RACING trial. The primary outcome was a 3-year composite of cardiovascular death, major cardiovascular events, or non-fatal stroke. Among total patients, 1398 (37.0%) had DM at baseline. The incidence of the primary outcome was 10.0% and 11.3% among patients with DM randomized to ezetimibe combination therapy vs. high-intensity statin monotherapy (hazard ratio: 0.89; 95% confidence interval: 0.64-1.22; P = 0.460). Intolerance-related discontinuation or dose reduction of the study drug was observed in 5.2% and 8.7% of patients in each group, respectively (P = 0.014). LDL cholesterol levels <70 mg/dL at 1, 2, and 3 years were observed in 81.0%, 83.1%, and 79.9% of patients in the ezetimibe combination therapy group, and 64.1%, 70.2%, and 66.8% of patients in the high-intensity statin monotherapy group (all P < 0.001). In the total population, no significant interactions were found between DM status and therapy regarding primary outcome, intolerance-related discontinuation or dose reduction, and the proportion of patients with LDL cholesterol levels <70 mg/dL. CONCLUSION: Ezetimibe combination therapy effects observed in the RACING trial population are preserved among patients with DM. This study supports moderate-intensity statin with ezetimibe combination therapy as a suitable alternative to high-intensity statins if the latter cannot be tolerated, or further reduction in LDL cholesterol is required among patients with DM and ASCVD. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, Identifier:NCT03044665.

Auteurs: Yong-Joon Lee, Jae Young Cho, Seng Chan You, Yong-Ho Lee, Kyeong Ho Yun, Yun-Hyeong Cho, Won-Yong Shin, Sang Wook Im, Woong Chol Kang, Yongwhi Park, Sung Yoon Lee, Seung-Jun Lee, Sung-Jin Hong, Chul-Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Jung-Sun Kim

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehac709. Bijgewerkt 2026-07-03T13:29:21Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.