Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis

Abstract As commonly used lipid-lowering drugs, the efficacy and safety of statins, ezetimibe, and fibrates, either alone or in combination, have rarely been systematically evaluated. Therefore, we conducted a network meta-analysis to assess their efficacy and safety in patients with hyperlipidemia....

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Main Authors: Shujie Zhang, Tingting Sun, Lina Song, Xiaodong Jin, Bo Li
Format: Article
Language:English
Published: BMC 2025-06-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02805-y
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author Shujie Zhang
Tingting Sun
Lina Song
Xiaodong Jin
Bo Li
author_facet Shujie Zhang
Tingting Sun
Lina Song
Xiaodong Jin
Bo Li
author_sort Shujie Zhang
collection DOAJ
description Abstract As commonly used lipid-lowering drugs, the efficacy and safety of statins, ezetimibe, and fibrates, either alone or in combination, have rarely been systematically evaluated. Therefore, we conducted a network meta-analysis to assess their efficacy and safety in patients with hyperlipidemia. In this study, we searched PubMed, the Cochrane Library, and Web of Science within our system. We included randomized controlled trials (RCTs) that compared the monotherapy or combination therapy of statins, ezetimibe, and fibrates for hyperlipidemia. Data analysis was performed using Stata 17.0 software. Each result is presented as the mean difference (MD) or odds ratio (OR) along with the 95% confidence interval (CI) and the surface under the cumulative ranking curve (SUCRA). A total of 30 studies, involving 10,219 patients, were included to analyze 12 different interventions. Combination therapy demonstrated superior therapeutic effects compared to monotherapy. Moderate-intensity statin + ezetimibe showed good efficacy and acceptable safety in reducing LDL cholesterol, while moderate-intensity statin + fibrate was a better choice for treating mixed dyslipidemia.
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institution Kabale University
issn 2047-783X
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series European Journal of Medical Research
spelling doaj-art-79f635a25fd04e40a718a48c75c8d85b2025-08-20T03:27:11ZengBMCEuropean Journal of Medical Research2047-783X2025-06-0130111910.1186/s40001-025-02805-yEfficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysisShujie Zhang0Tingting Sun1Lina Song2Xiaodong Jin3Bo Li4School of Clinical Medicine, Shandong Second Medical UniversitySchool of Clinical Medicine, Shandong Second Medical UniversityDepartment of Health Education, Maternal and Child, Health Care Hospital of ZiboDepartment of Geriatrics, Zibo Central HospitalDepartment of Cardiology, Zibo Central HospitalAbstract As commonly used lipid-lowering drugs, the efficacy and safety of statins, ezetimibe, and fibrates, either alone or in combination, have rarely been systematically evaluated. Therefore, we conducted a network meta-analysis to assess their efficacy and safety in patients with hyperlipidemia. In this study, we searched PubMed, the Cochrane Library, and Web of Science within our system. We included randomized controlled trials (RCTs) that compared the monotherapy or combination therapy of statins, ezetimibe, and fibrates for hyperlipidemia. Data analysis was performed using Stata 17.0 software. Each result is presented as the mean difference (MD) or odds ratio (OR) along with the 95% confidence interval (CI) and the surface under the cumulative ranking curve (SUCRA). A total of 30 studies, involving 10,219 patients, were included to analyze 12 different interventions. Combination therapy demonstrated superior therapeutic effects compared to monotherapy. Moderate-intensity statin + ezetimibe showed good efficacy and acceptable safety in reducing LDL cholesterol, while moderate-intensity statin + fibrate was a better choice for treating mixed dyslipidemia.https://doi.org/10.1186/s40001-025-02805-yNetwork analysisCholesterolLipidsAdverse eventsAdverse drug reactionsEfficacy
spellingShingle Shujie Zhang
Tingting Sun
Lina Song
Xiaodong Jin
Bo Li
Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
European Journal of Medical Research
Network analysis
Cholesterol
Lipids
Adverse events
Adverse drug reactions
Efficacy
title Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
title_full Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
title_fullStr Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
title_full_unstemmed Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
title_short Efficacy and safety of statins, ezetimibe, and fibrates monotherapy or combination therapy for hyperlipidemia: a systematic review and network meta-analysis
title_sort efficacy and safety of statins ezetimibe and fibrates monotherapy or combination therapy for hyperlipidemia a systematic review and network meta analysis
topic Network analysis
Cholesterol
Lipids
Adverse events
Adverse drug reactions
Efficacy
url https://doi.org/10.1186/s40001-025-02805-y
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