Evidence map›Paper›PMID 24766978›Full record

Trial reportAmerican heart journal2014

Impact of the ENHANCE trial on the use of ezetimibe in the United States and Canada.

Lingyun Lu, Harlan M Krumholz, Jack V Tu, Joseph S Ross, Dennis T Ko, Cynthia A Jackevicius

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in American heart journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pharmaceutical policies: effects of policies regulating drug marketing.The Cochrane database of systematic reviews · 2023
    Pooled it
  2. Article
  3. Article
  4. Impact of drug policy on regional trends in ezetimibe use.Circulation. Cardiovascular quality and outcomes · 2014
    Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lingyun LuDepartment of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, CA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA.
Harlan M KrumholzDepartment of Medicine, Section of Cardiovascular Medicine; Yale University School of Medicine, Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT; Department of Epidemiology and Public Health, Section of Health Policy and Administration, New Haven, CT; Robert Wood Johnson Clinical Scholars Program, New Haven, CT.
Jack V TuInstitute for Clinical Evaluative Sciences, Toronto, Canada; Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Joseph S RossYale University School of Medicine, Center for Outcomes Research and Evaluation, Yale New Haven Hospital, New Haven, CT; Department of Medicine, Section of General Internal Medicine, New Haven, CT.
Dennis T KoInstitute for Clinical Evaluative Sciences, Toronto, Canada; Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada; Division of Cardiology, Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada.
Cynthia A JackeviciusDepartment of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, Pomona, CA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA; Institute for Clinical Evaluative Sciences, Toronto, Canada; Department of Health Policy, Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada; University Health Network, Toronto, Canada. Electronic address: cjackevicius@westernu.edu.

Funding

Center for Cardiovascular Outcomes Research at Yale UniversityU01HL105270 · NHLBI · YALE UNIVERSITY · PI CURTIS, JEPTHA PELHAM, KRUMHOLZ, HARLAN MARC · 2010 to 2013
$5.8M
Impact of Publicity Reporting Hospital Outcome Measures for Older AdultsK08AG032886 · NIA · YALE UNIVERSITY · PI ROSS, JOSEPH SOLOMON · 2008 to 2012
$738k
CIHRNHLBI NIH HHS U01 HL105270NHLBI NIH HHS U01-HL105270NIA NIH HHS K08 AG032886
6 · The paper itself

Abstract

backgroundWe previously found that the use of ezetimibe increased rapidly with different patterns between the United States (US) and Canada prior to the landmark Ezetimibe and Simvastatin in Hypercholesterolemia Enhance Atherosclerosis Regression (ENHANCE) trial, which was reported in January 2008, and failed to show that the drug slowed the progression of atherosclerosis. What is not known is how practice in the 2 countries changed after the ENHANCE trial. We examined ezetimibe use trends in the US and Canada before and after the reporting of the ENHANCE trial.

methodsWe conducted a population-based, retrospective, time-series analysis using the data collected by IMS Health in the US and CompuScript in Canada from January 1, 2002, to December 31, 2009. The main outcome measure was monthly number of prescriptions for ezetimibe-containing products.

resultsThe monthly number of ezetimibe prescriptions/100,000 population rose from 6 to 1,082 in the US from November 2002 to January 2008, then significantly declined to 572/100,000 population by December 2009 after the release of the ENHANCE trial, a decrease of 47.1% (P < .001). In contrast, in Canada, use continuously rose from 2 to 495/100,000 population from June 2003 to December 2009 (P = .2). United States expenditures totaled $2.24 billion in 2009.

conclusionsEzetimibe remains commonly used in both the US and Canada. Ezetimibe use has decreased in the US post-ENHANCE, whereas use has gradually but steadily increased in Canada. The diverging patterns of ezetimibe use in the US and Canada require further investigation, as they reveal that a common evidence base is eliciting very different utilization patterns in neighboring countries.

Indexed as

Anticholesteremic AgentsAtherosclerosisAzetidinesCanadaCholesterolDisease ProgressionDose-Response Relationship, DrugDrug CostsDrug PrescriptionsEzetimibeFollow-Up StudiesHumansHypercholesterolemiaPrevalenceRetrospective StudiesTime FactorsAnticholesteremic AgentsAzetidinesCholesterolEzetimibe

Identifiers

PMID24766978
PMCPMC4215424

What Socratic holds

Texttitle and abstract
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.