What is the effect of the addition of ezetimibe to statins on patients with diabetes mellitus (DM)?
In patients with DM, statin plus ezetimibe reduced the seven-year Kaplan-Meier (KM) event rate in the composite endpoint more than statins alone (HR: 0.85, 95% CI: 0.78 0.94, NNT=18). In patients without DM, the absolute difference in the primary composite outcome was 0.7% and not statistically different over a seven-year period (HR: 0.98, 95% CI: 0.91 1.04). When the authors applied the TRS tool, all patients with DM had a statistically significant benefit regardless of risk. However, in patients without DM and determined to be at low to intermediate risk based upon the TRS tool, no benefit was observed with combination therapy.