The effect of ezetimibe, administered alone or in combination with simvastatin, on lymphocyte cytokine release in patients with elevated cholesterol levels

. Krysiak R, Zmuda W, Okopien B (Medical University of Silesia, Katowice; and and Electrotherapy and Angiology Centre, Oswiecim, Poland). The effect of ezetimibe, administered alone or in combination with simvastatin, on lymphocyte cytokine release in patients with elevated cholesterol levels. J Intern Med 2012; 271: 32–42. Objective. Studies assessing the extra‐lipid effects of ezetimibe have provided contrasting results. In the present study, we compared the effects of ezetimibe and simvastatin, administered alone or in combination, on the secretory function of human lymphocytes, systemic inflammation and endothelial function in subjects with elevated cholesterol levels. Methods. A prospective study involving a group of 178 ambulatory patients with isolated hypercholesterolaemia who were randomly assigned in a double‐blind fashion to 90 days of treatment with ezetimibe (10 mg), simvastatin (40 mg), ezetimibe (10 mg) plus simvastatin (40 mg) or placebo. A total of 170 patients completed the study. Main outcome measures. Lymphocyte cytokine release and plasma levels of high‐sensitivity C‐reactive protein (hsCRP) and intercellular adhesion molecule 1 (ICAM‐1). Results. Although both drugs reduced lymphocyte release of tumour necrosis factor‐α, interferon‐γ and interleukin‐2 in a lipid‐independent manner, only the effect of simvastatin was statistically significant (P