The lowering of low-density lipoprotein cholesterol (LDL-C) is the primary target of therapy in the primary and secondary prevention of cardiovascular events. Although statin therapy is the mainstay for LDL-C lowering, a significant percentage of patients prescribed these agents either do not achieve targets with statin therapy alone or have partial or complete intolerance to them. For such patients, the use of adjuvant therapy capable of providing incremental LDL-C reduction is advised. One such agent is ezetimibe, a cholesterol absorption inhibitor that targets uptake at the jejunal enterocyte brush border. Its primary target of action is the cholesterol transport protein Nieman Pick C1 like 1 protein. Ezetimibe is an effective LDL-C lowering agent and is safe and well tolerated. In response to significant controversy surrounding the use and therapeutic effectiveness of this drug, we provide an update on the biochemical mechanism of action for ezetimibe, its safety and efficacy, as well as the results of recent randomized studies that support its use in a variety of clinical scenarios.

/pdf/ezetimibe-therapy-mechanism-of-action-and-clinical-update-4knzeg3t99.pdf

Ezetimibe therapy: mechanism of action and clinical update

https://www.gastrojournal.org/article/S0016-5085(09)01571-6/pdf

Long-term Probability of and Mortality From De Novo Malignancy After Liver Transplantation

Risk of malignant neoplasms after liver transplantation: A population‐based study

https://dadun.unav.edu/bitstream/10171/27483/1/Liver%20transpl.%202005.%2089.pdf

De Novo neoplasia after liver transplantation: an analysis of risk factors and influence on survival.

De novo internal neoplasms after liver transplantation: increased risk and aggressive behavior in recent years?

Ezetimibe is the first member of a new family of lipid-lowering drugs that inhibits uptake of dietary and biliary cholesterol. It was approved by the FDA in 2002 for hypercholesterolemia alone or in combination with statins. Its use has been spreading over the last years. Ezetimibe was considered a safe drug. We report a case of a woman who developed a serious hepatocellular drug-induced liver disease after 4 mo therapy with 10 mg daily of ezetimibe. After withdrawal of the drug, the patient recovered slowly. Ezetimibe may produce serious toxic hepatitis and prompt withdrawal is mandatory in case of a significant abnormality in liver testing after beginning or during treatment with ezetimibe.

/pdf/serious-drug-induced-liver-disease-secondary-to-ezetimibe-2ezs3zwn5q.pdf

Serious drug-induced liver disease secondary to ezetimibe.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jlts.2001.28744

Risk factors for development of de novo neoplasia after liver transplantation.

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Serious drug-induced liver disease secondary to ezetimibe.

Risk factors for development of de novo neoplasia after liver transplantation.