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Inhibition of microsomal triglyceride transfer protein alone or with ezetimibe in patients with moderate hypercholesterolemia
Abstract
Background Many patients with coronary heart disease do not achieve recommended LDL-cholesterol levels, due to either intolerance or inadequate response to available lipid-lowering therapy. Microsomal triglyceride transfer protein (MTP) inhibitors might provide an alternative way to lower LDL-cholesterol levels. We tested the safety and LDL-cholesterol-lowering efficacy of an MTP inhibitor, AEGR-733 (Aegerion Pharmaceuticals Inc., Bridgewater, NJ), alone and in combination with ezetimibe.Methods We performed a multicenter, double-blind, 12-week trial, which included 84 patients with hypercholesterolemia. Patients were randomly assigned ezetimibe 10 mg daily (n = 29); AEGR-733 5.0 mg daily for the first 4 weeks, 7.5 mg daily for the second 4 weeks and 10 mg daily for the last 4 weeks (n = 28); or ezetimibe 10 mg daily and AEGR-733 administered with the dose titration described above (n = 28).Results Ezetimibe monotherapy led to a 20-22% decrease in LDL-cholesterol concentrations. AEGR-733 monotherapy led to a dose-dependent decrease in LDL-cholesterol concentration: 19% at 5.0 mg, 26% at 7.5 mg and 30% at 10 mg. Combined therapy produced similar but larger dose-dependent decreases (35%, 38% and 46%, respectively). The number of patients who discontinued study drugs owing to adverse events was five with ezetimibe alone, nine with AEGR-733 alone, and four with combined ezetimibe and AEGR-733. Discontinuations from AEGR-733 were due primarily to mild transaminase elevations.Conclusions Inhibition of LDL production with low-dose AEGR-733, either alone or in combination with ezetimibe, could be an effective therapeutic option for patients unable to reach target LDL-cholesterol levels.
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Metadata
- Authors
- Samaha, F. F., McKenney, J., Bloedon, L. T., Sasiela, W. J., & Rader, D. J.
- Affiliations
- Philadelphia VA Medical Center (US)
- Virginia Commonwealth University (US)
- University of Pennsylvania (US)
- Aegerion Pharmaceuticals (United States) (US)
- Corresponding author
- Samaha, Frederick F
- Venue
- Nature Clinical Practice Cardiovascular Medicine
- Published
- 2008-05-27
- Volume
- 5
- Issue
- 8
- Pages
- 497-505
- ISSN
- 1743-4297 (ISSN-L)
- 1743-4300
- OpenAlex
- W2046959088
- Cited by
- 220
- References
- 31
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 11 · 2023: 4 · 2022: 11 · 2021: 5 · 2020: 4 · 2019: 7 · 2018: 10 · 2017: 8 · 2016: 15 · 2015: 18 · 2014: 29 · 2013: 27 · 2012: 23
- FWCI
- 13.35
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Clinical Practice Cardiovascular Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Keywords
- microsomal triglyceride transfer protein, MTP inhibitors, ezetimibe, hypercholesterolemia, LDL cholesterol lowering, combination lipid-lowering therapy, dose titration, transaminase elevation, drug safety, coronary artery disease, statin intolerance, treatment response variability, triglyceride-rich lipoproteins
- MeSH terms
- Ezetimibe, Aged, Anticholesteremic Agents, Azetidines, Benzimidazoles, Carrier Proteins, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Hypercholesterolemia, Cholesterol, LDL, Male, Microsomes, Middle Aged, Severity of Illness Index, Treatment Outcome
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