Combining Merck & Co and Schering Plough’s ezetimibe with statin drugs provides significant benefits in patients with elevated cholesterol, according to studies presented at the World Congress of Cardiology in Barcelona, Spain.

Adding ezetimibe to AstraZeneca’s Crestor (rosuvastatin) was found to cut levels of C-reactive protein – a market of inflammation and risk factor for cardiovascular disease – by 46%, compared to a reduction of just 29% with Crestor alone, according to new data from the EXPLORER study.

Meanwhile, a study of ezetimibe plus the statin simvastatin (which was originally developed by Merck & Co and now available generically in a number of markets including the USA) found that the combination cut CRP by 31%, versus 14% for simvastatin alone.

Likewise ezetimibe plus simvastatin reduced levels of apolipoprotein B-containing lipoprotein particles such as LDL-c, another risk factor for cardiovascular disease, by a greater margin than simvastatin alone. LDL-c was slashed by 38% with simvastatin and 53% by the combination regimen in the study.

In EXPLORER, Crestor and ezetimibe cut LDL-c by 70%, described by AstraZeneca as an ‘unprecedented’ margin.

“Physicians have long relied on blood cholesterol as a key indicator of cardiovascular risk, but recent research suggests that adding a CRP goal to existing LDL-c targets could potentially further reduce the risk of cardiovascular outcomes,“ said EXPLORER lead investigator Professor Christie Ballantyne of Baylor College of Medicine in the USA.

A fixed-dose combination of ezetimibe and simvastatin is already sold as Inegy in Europe and Vytorin in the USA by Merck and Schering-Plough. Meanwhile, ezetimibe is already sold as a monotherapy (as Zetia/Ezetrol) and licensed for use alongside statins, so cardiologists can elect to prescribe the drug alongside Crestor.

Ezetimibe works by inhibiting the absorption of cholesterol in the gastrointestinal tract, while statins block the production of cholesterol in the liver.