Summary

In this article the primary investigator in the ENHANCE study presents the study results to address the controversy surrounding its results. ENHANCE was performed in patients with heterozygous familial hypercholesterolemia (HeFH), a genetic mutation affecting the LDL receptor that occurs in 0.2% of the population and results in average LDLs >300 mg/dL. Unlike these prior trials, ENHANCE evaluated whether ezetimibe (a selective inhibitor of cholesterol absorption in the small intestine), when added to simvastatin, reduced the progression of atherosclerosis compared with simvastatin alone in patients with HeFH.