Effects of Combined Ezetimibe and Simvastatin Therapy as Compared With Simvastatin Alone in Patients With Type 2 Diabetes: A Prospective Randomized Double-Blind Clinical Trial Response to Sarigianni, Katsiki, and Mikhailidis

Sarigianni et al. (1) properly pointed out that in the Ezetimibe and Simvastatin in dyslipidemia of Diabetes (ESD) randomized clinical trial "the serum HDL cholesterol was significantly lower after adding ezetimibe compared with simvastatin monotherapy." The concomitant reduction in LDL cholesterol observed during simvastatin and ezetimibe combination therapy, however, exceeded the decrease in HDL cholesterol (2). Consequently, the LDL-to-HDL cholesterol ratio decreased from (mean ± SD) 2.11 ± 0.64 at randomization