The effect of ezetimibe monotheraphy on mean platelet volume in patients with hyperlipidaemia: a retrospective study of 45 patients.

OBJECTIVE: To investigate the effect of ezetimibe on platelet functions as a drug which increases mevalonate levels. METHODS: This retrospective study was conducted in Istanbul, Turkey, and comprised record of normolipidaemic and hyperlipidaemic patients taken from the outpatient clinic from October 2004 to February 2015,. The results were taken from the baseline and third-month data of ezetimibe treatment. SPSS 22 was used for statistical analysis. RESULTS: Of the total, there were 50(53%) normolipidaemic patients and 45(47%) hyperlipidaemic ones. Pre- and post-treatment values of mean platelet volume were significantly higher in the hyperlipidaemic group than controls (p<0.001). In the hyperlipidaemic group there was no significant difference between pre- and post-treatment values of mean platelet volume (8.96±0.93 vs. 8.92±0.84; p>0.05). CONCLUSIONS: The use of ezetimibe alone should not be the first choice in hyperlipidaemia treatment.

Biological Subtypes and Distant Relapse Pattern in Breast Cancer Patients After Curative Surgery (Study of Anatolian Society of Medical Oncology).

PURPOSE: The aim of the study was to investigate the association between the molecular subtypes and patterns of relapse in breast cancer patients who had undergone curative surgery. METHODS: We retrospectively evaluated 1,350 breast cancer patients with relapses after curative surgery between 1998 and 2012 from referral centers in Turkey. Patients were divided into 4 biological subtypes according to immunohistochemistry and grade: triple negative, HER2 overexpressing, luminal A and luminal B. RESULTS: The percentages of patients with luminal A, luminal B, HER2-overexpressing, and triple-negative breast cancer were 32.9% (n = 444), 34.9% (n = 471), 12.0% (n = 162), and 20.2% (n = 273), respectively. The distribution of metastases differed among the subgroups: bone (66.2% and 53.9% in luminal A and B vs. 38.9% in HER2-overexpressing and 45.1% in triple negative, p < 0.001), liver (40.1% in HER2-overexpressing vs. 24.5% in luminal A, 33.5% in luminal B, and 27.5% in triple negative, p < 0.001), lung (41.4% in triple negative and 35.2% in HER2-overexpressing vs. 30.2% and 30.6% in luminal A and B, p = 0.008) and brain (25.3% in HER2-overexpressing and 23.1% in triple negative vs. 10.1% and 15.1% in luminal A and B, p < 0.001). CONCLUSIONS: Organ-specific metastasis may depend on the molecular subtype of breast cancer. Tailored strategies against distant metastasis concerning the molecular subtypes in breast cancer should be considered.

Ezetimibe effect on bone mineral density and markers of bone formation and resorption.

BACKGROUND: Ezetimibe, as a lipid-lowering agent, inhibits the intestinal absorption of cholesterol and decreases low-density lipoprotein cholesterol (LDL-C) level in serum. It also up-regulates hepatic cholesterol biosynthesis and, by contrast to statins, increases serum mevalonate levels. Statins and biphosphonates decrease osteoclastic activity through the same mechanisms by inhibiting the mevalonate pathway. We therefore tested the effect of ezetimibe on bone turnover in hypercholesterolemic patients. SUBJECT AND METHODS: In an open-label clinical trial, 54 hypercholesterolemic patients included in the study underwent 12 months of treatment with ezetimibe at a dosage of 10 mg/d. Before and after the 1-year ezetimibe treatment, bone mineral density (BMD) was measured by dual-energy x-ray absorptiometry and serum samples taken for measurements of levels of total cholesterol (TC), triglyceride, high-density lipoprotein cholesterol and LDL-C, serum calcium (Ca), serum phosphate, total and bone alkaline phosphatases (ALPs), and carboxyterminal fragment of type 1 collagen in the serum. RESULTS: The hypercholesterolemic patients showed a significant reduction with respect to baseline TC and LDL-C serum levels: 20% for TC (270.18 [38.58]-214.46 [38] mg/dL) and 24% for LDL-C (189.57 [38.58]-144 [32.05] mg/dL). Biochemical markers of both bone formations (total ALP level, 65.50 [21.33]-66.27 [21.017] IU/L and bone ALP level, 55.93 [7.92]-56.25 [7.49] IU/L) and bone resorption (beta-CTx, 0.44 [0.24]-0.46 [0.21] ng/mL) increased but did not show any significant change for the whole study period. At the end of 1 year, both BMD-lumbar spine (0.90 [0.12]-0.89 [0.08] g/cm) and BMD-total femur (0.93 [0.12]-0.92 [0.12] g/cm) showed a negative trend but without reaching statistical significance. CONCLUSIONS: Our study results showed a negative trend but did not demonstrate statistically significant changes of BMD and metabolic markers with the treatment of ezetimibe.