Inegy - Effective combination treatment to target LDL-C levels

Aggressive lipid lowering can improve cardiovascular outcomes, particularly among high-risk patients. However, many patients fail to achieve increasingly stringent LDL-C goals when treated in clinical practice. Consequently, novel approaches to lipid management are required. Inegy (Vytorin in the USA) combines two lipid-modifying drugs, ezetimibe and simvastatin, which have complementary mechanisms of action. By inhibiting two independent pathways of plasma cholesterol generation - the exogenous pathway of cholesterol absorption from the gut (via ezetimibe) and the endogenous pathway of cholesterol biosynthesis in the liver (via simvastatin) - Inegy reduces plasma LDL-C levels and also improves other elements of the lipid profile. A number of clinical studies have consistently demonstrated that Inegy provides more potent LDL-C lowering than statin monotherapy. Indeed, the reductions in LDL-C associated with low-dose Inegy appear to be similar to those achieved by monotherapy with maximum doses of even the most potent statins. Thus, Inegy reduces the need for statin dose titration, potentially reducing the adverse events associated with high-dose statin monotherapy. Moreover, the safety and tolerability profile of Inegy appears to be similar to low-dose statin monotherapy. These findings suggest that Inegy represents a useful addition to the lipid management strategies that are currently available to clinicians.