Ezetimibe: cholesterol lowering and beyond

Expert Rev Cardiovasc Ther. 2008 Apr;6(4):447-70. doi: 10.1586/14779072.6.4.447.

Abstract

Ezetimibe is a cholesterol absorption inhibitor that blocks the intestinal absorption of both biliary and dietary cholesterol. It appears to exert its effect by blocking intestinal sterol transporters, specifically Niemann-Pick C1-like 1 proteins, thereby inhibiting the intestinal absorption of cholesterol, phytosterols and certain oxysterols. Ezetimibe monotherapy and in combination with statin therapy is primarily indicated for lowering LDL-cholesterol levels. In addition, it may favorably affect other parameters that could potentially further reduce atherosclerotic coronary heart disease risk, such as raising HDL-cholesterol and lowering levels of triglycerides, non-HDL-cholesterol, apolipoprotein B and remnant-like particle cholesterol. Further effects of ezetimibe include a reduction in circulating phytosterols and oxysterols and, when used in combination with statins, a reduction in high-sensitivity C-reactive protein. The clinical significance of the LDL-cholesterol lowering and other effects of ezetimibe is being evaluated in clinical outcome studies.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents / pharmacology
  • Anticholesteremic Agents / therapeutic use*
  • Azetidines / pharmacology
  • Azetidines / therapeutic use*
  • Cholesterol / metabolism
  • Controlled Clinical Trials as Topic
  • Coronary Disease / prevention & control
  • Drug Therapy, Combination
  • Ezetimibe
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypercholesterolemia / drug therapy*

Substances

  • Anticholesteremic Agents
  • Azetidines
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol
  • Ezetimibe