RACING - long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy

Last edited 08/2022 and last reviewed 08/2023

• a multicenter, open-label trial shows that moderate-intensity statin with ezetimibe combination therapy is non-inferior to high-intensity statin monotherapy in patients with ASCVD (atherosclerotic cardiovascular disease) in the long term
  • a multicenter, open-label, non-inferiority trial in 26 hospitals in South Korea
    • patients aged 19-80 years with ASCVD (n=3780) were randomized to moderate-intensity statin (rosuvastatin 10 mg once daily) with ezetimibe (10 mg once daily) combination therapy or high-intensity statin (rosuvastatin 20 mg once daily) monotherapy
      • randomization was stratified by LDL-c concentration (< 100 mg/dL) and presence of diabetes at baseline
      • ASCVD was defined as the presence or occurrence of myocardial infarction, acute coronary syndrome, coronary revascularization or other arterial revascularization, ischemic stroke, or PAD (peripheral arterial disease)
      • patients with active liver disease or a life expectancy <3 years, donor organ recipients, and pregnant or lactating women were excluded from participation
      • atients were followed up for 3 years
• within 3 years, the primary outcome, which was a composite of cardiovascular death, major cardiovascular events, and non-fatal stroke, occurred equally often in both groups
• in the combination therapy group, the percentage of patients with an LDL-c concentration < 70 mg/dL was higher and the percentage of patients in whom treatment had to be discontinued or the dose reduced was lower than in the monotherapy group.

Reference:

• Kim BK, Hong SJ, Lee YJ, et al. Long-term efficacy and safety of moderate-intensity statin with ezetimibe combination therapy versus high-intensity statin monotherapy in patients with atherosclerotic cardiovascular disease (RACING): a randomised, open-label, non-inferiority trial Lancet. 2022 Jul 18:S0140-6736(22)00916-3. doi: 10.1016/S0140-6736(22)00916-3.