Article date: July 2017
By: Eva Dolezelova, Evan Stein, Giuseppe Derosa, Pamela Maffioli, Petr Nachtigal, Amirhossein Sahebkar in Volume 83, Issue 7, pages 1380-1396
Aims
Statins are known to influence the status of adipokines, which play a key role in the pathophysiology of cardiometabolic diseases. As the effect of ezetimibe as an add‐on to statin therapy on the impact of statins on plasma adipokines levels is currently unclear, the aim of the present study was to investigate this through a meta‐analysis of controlled trials.
Methods
A systematic review was performed, followed by a bibliographic search in PubMed, Medline, SCOPUS, Web of Science and Google Scholar databases. Quantitative data synthesis was performed using a fixed‐ or random‐effects model (based on the level of interstudy heterogeneity) and the generic inverse variance weighting method. Effect sizes were expressed as standardized mean difference (SMD) and 95% confidence interval (CI).
Results
Meta‐analysis of 23 controlled trials did not suggest any significant effect of adding ezetimibe on top of statin therapy on plasma concentrations of adiponectin (SMD 0.34, 95% CI –0.28, 0.96; P = 0.288), leptin (SMD –0.75, 95% CI: –2.35, 0.85; P = 0.360), plasminogen activator inhibitor 1 (SMD –1.06, 95% CI: –2.81, 0.69; P = 0.236) and interleukin 6 (SMD 0.30, 95% CI: –0.08, 0.67; P = 0.124). However, significantly greater reductions in plasma concentrations of tumour necrosis factor α (TNF‐α) (SMD –0.48, 95% CI –0.87, −0.08; P = 0.018) were achieved with ezetimibe/statin combination therapy.
Conclusions
The results suggested that ezetimibe add‐on to statin therapy is associated with an enhanced TNF‐α‐lowering effect compared with statin monotherapy. Owing to the emerging role of TNF‐α in the pathogenesis of metabolic disorders, further investigations are required to unveil the translational relevance of this TNF‐α‐lowering effect.
DOI: 10.1111/bcp.13250
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