What is the recommended use of Ezetimibe before PCSK9 inhibitor?
Ezetimibe use before PCSK9 inhibitor is recom- mended because ezetimibe is available as a generic drug and has proven safety.211 This approach is supported by 2 simulation studies from large populations of very high-risk patients showing that ezetimibe plus statin therapy lowers LDL-C to <70 mg/ dL (1.8 mmol/L) in most patients, leaving a minority eligible for a PCSK9 inhibitor.217,218 In addition, the TST trial of patients with ischemic stroke used ezetimibe as second-line therapy to achieve the LDL-C target.