This is a study to evaluate the lipid-altering efficacy, safety, and tolerability of ezetimibe when added to ongoing therapy with an 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase inhibitor (statin) in participants with primary hypercholesterolemia, multiple cardiovascular risk factors, or known coronary heart disease (CHD) or CHD-equivalent disease. The statin and dose in use by the participant at screening will be maintained at the same dose for the 8-week treatment phase of the study. Following the treatment, there will be a 6-week cholesterol reversibility phase to determine the rebound effect on cholesterol after ezetimibe is discontinued, but the participant is still on their statin therapy. The primary hypothesis is that the addition of ezetimibe 10 mg/day to ongoing statin monotherapy will result in a further reduction in low-density lipoprotein-cholesterol (LDL-C) compared with placebo. The protocol was amended to include an extension for participants who complete the base study. The extension will evaluate the safety and tolerability of concomitant treatment of simvastatin with ezetimibe10 mg/day over a 1-year period. All participants in the extension will be converted from current statin to an equivalent dose of simvastatin for 6 weeks. Participants then will be randomly assigned to receive simvastatin coadministered with either with Ezetimibe 10 mg daily or matching placebo for the reminder of study.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
769
10 mg tablet, oral, once daily
one tablet, oral, once daily
Once daily administration at dose to be determined
Statin administered orally once daily at dose determined by treatment prior to enrollment by personal physician
Percentage Change from Baseline in LDL-C: Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Participants with Consecutive Elevations ≥3 x Upper Limit of Normal (ULN) in Aspartate Aminotransferase (AST) or Alanine Aminotransferase (ALT): Extension
Time frame: up to 48 weeks (Extension)
Percentage of Participants Achieving LDL-C National Cholesterol Education Program (NCEP) Adult Treatment Program II (ATP II) Target Levels: Base Study
Time frame: Week 8 of Base Study
Percentage Change from Baseline in Total Cholesterol (TC) : Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Triglycerides (TG): Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in High-density Lipoprotein-cholesterol (HDL-C) : Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Non-HDL-C: Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Apolipoprotein B (apoB) : Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Apolipoprotein A-I (Apo A-I) : Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Apolipoprotein A-II (Apo A-II) : Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in LDL-C:HDL-C Ratio: Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in Total-C:HDL-C Ratio: Base Study
Time frame: Baseline and Week 8 of Base Study
Change from Baseline in C-reactive Protein (CRP): Base Study
Time frame: Baseline and Week 8 of Base Study
Percentage Change from Baseline in LDL-C: Extension
Time frame: Baseline (Week 6) and Week 18 of Extension
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