A Retrospective Study of LDL-Cholesterol in Koreans on Atorvastatin/Ezetimibe or Atorvastatin Monotherapy

Purpose: To investigate low-density lipoprotein cholesterol (LDL-C) goal attainment rates in patients with hypercholesterolemia treated with atorvastatin/ezetimibe or atorvastatin monotherapy. Methods: This was a multicenter, noninterventional, retrospective, chart review study of Korean patients with hypercholesterolemia who were statin-naïve and prescribed atorvastatin/ezetimibe or atorvastatin monotherapy during an observational period, from January 2014 to July 2017, and followed up for 12–18 weeks. Patients were propensity score matched to reduce treatment selection bias. Outcomes included LDL-C goal attainment rate at week 12, defined by risk groups according to Korean Society of Lipidology and Atherosclerosis guidelines; and change in lipid parameters from the index date to week 12. Results: A total of 969 patients were enrolled in the study: atorvastatin/ezetimibe, n = 349; atorvastatin monotherapy, n = 620. Following propensity matching (n = 316 in each group), respective LDL-C goal attainment rates for atorvastatin/ezetimibe and atorvastatin monotherapy groups were 86% and 75%, respectively (p = 0.0004). Atorvastatin/ezetimibe produced significantly larger reductions at week 12 in mean LDL-C (−50.3% vs −42.7%), total cholesterol (−36.8% vs −30.7%) and non-high-density lipoprotein cholesterol (non-HDL-C; −47.3% vs −39.8%) levels compared to atorvastatin monotherapy (all p < 0.0001). Conclusion: More patients achieved LDL-C goal attainment with atorvastatin/ezetimibe than with atorvastatin monotherapy, and atorvastatin/ ezetimibe was associated with significantly larger reductions in mean LDL-C, total cholesterol and non-HDL-C levels than atorvastatin monotherapy, in Korean patients with hypercholesterolemia in a real-world clinical practice.