Cost regulators for the NHS in England and Wales have backed the use of MSD’s Ezetrol for adults with high cholesterol.

In final guidelines, the National Institute for Health and Care Excellence says the drug can be used as a monotherapy to treat adult patients with primary (heterozygous_familial or non_familial) hypercholesterolaemia in whom initial statin therapy is contraindicated or not tolerated.

Ezetrol (ezetimibe) is also recommended in combination with initial statin therapy as an option when cholesterol concentration is not appropriately controlled, or where a person is unable to have higher doses of the statin because it is likely to cause side effects, and a change to an alternative statin is being considered. 

Primary heterozygous-familial hypercholesterolaemia is an inherited condition caused by a faulty gene that affects around 120,000 people in the UK. Non-familial hypercholesterolaemia develops from a mix of genetic traits and other factors such as diet, smoking and lack of exercise, and is thought to affect around 2,000,000 people. In both cases, raised levels of cholesterol put patients at higher risk of developing CVD, the leading cause of death in the country.

Ezetrol is a cholesterol-absorption inhibitor that blocks intestinal absorption of dietary and biliary cholesterol and related plant sterols, but without affecting uptake of triglycerides or fat-soluble vitamins. This means that the drug can be combined with a statin to provide either a complementary or an alternative mode of cholesterol reduction.