Ezetimibe reduces plant sterol accumulation and favorably increases platelet count in sitosterolemia

Rgia A. Othman, Semone B. Myrie, David Mymin, Louise S. Merkens, Jean Baptiste Roullet, Robert D. Steiner, Peter J.H. Jones

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Objective: To assess if ezetimibe (EZE), a sterol-absorption inhibitor, improves platelet (PLT) count and size relative to its effect on plasma plant sterol (PS) in patients with sitosterolemia (STSL). Study design: Patients with STSL (5 males, 3 females, 16-56 years of age) receiving EZE intervention as part of their routine care participated in this study. EZE was discontinued for 14 weeks (off) and then resumed for another 14 weeks (on). Hematology variables along with plasma and red blood cells (RBC) PS and total cholesterol (TC) levels were measured at the end of each phase. Results: EZE increased PLT count (23% ± 9%) and decreased mean PLT volume (MPV; 10% ± 3%, all P < .05). In patients off EZE, PLT counts inversely correlated (r = -0.96 and r = -0.91, all P < .01) with plasma and RBC PS to TC ratio (PS/TC), and MPV positively correlated (r = 0.91, P = .03 and r = 0.93, P = .02) with plasma and RBC PS/TC. EZE reduced plasma and RBC sitosterol (-35% ± 4% and -28% ± 3%), total PS (-37% ± 4% and -28% ± 3%, all P < .0001) levels, and PS/TC (-27% ± 4% and -28% ± 4%, P < .01). Conclusions: EZE reduces plasma and RBC PS levels, while increasing PLT count and decreasing MPV, and thereby may reduce the risk for bleeding in STSL. Plasma PS levels and ABCG5/ABCG8 genes should be analyzed in patients with unexplained hematologic abnormalities.

Original languageEnglish (US)
Pages (from-to)125-131
Number of pages7
JournalJournal of Pediatrics
Issue number1
StatePublished - Jan 1 2015


  • ABC
  • Adenosine triphosphate-binding cassette
  • EZE
  • Ezetimibe
  • Hb
  • Hemoglobin
  • LDL
  • Low-density lipoprotein
  • MCHC
  • MPV
  • Mean PLT volume
  • Mean corpuscular hemoglobin concentration
  • PLT
  • PS
  • PS to TC ratio
  • PS/TC
  • Plant sterol
  • Platelet
  • RBC
  • RDW
  • Red blood cells
  • Red cell distribution width
  • STSL
  • Sitosterolemia
  • TC
  • Total cholesterol

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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