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Optimal lipid modification: the rationale for combination therapy.

James M Backes1, Cheryl A Gibson, Patricia A Howard

  • 1Department of Pharmacy Practice, Lipid, Atherosclerosis, Metabolic and LDL Apheresis Center, University of Kansas Medical Center, Kansas City, KS 66160-7231, USA. jbackes@kumc.edu

Vascular Health and Risk Management
|February 24, 2007
PubMed
Summary
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Combination lipid-lowering drugs improve lipoprotein profiles and may reduce cardiovascular events more than single therapies. Evidence supports their use despite concerns about side effects and adherence.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Lipid Metabolism

Background:

  • Aggressive lipid-lowering, especially for low-density lipoprotein cholesterol, is emphasized for improved patient outcomes.
  • Combination lipid-lowering drug use has increased, raising concerns about adverse effects, drug interactions, and adherence.

Purpose of the Study:

  • To review data on combination lipid-altering therapy.
  • Key aspects include use, rationale, trials, benefits, adverse effects, compliance, and limitations.

Main Methods:

  • Literature search of MEDLINE (1966-2005) and article references.
  • Focused on studies evaluating combination lipid-altering agents.

Main Results:

  • Epidemiological and clinical data link aggressive lipid modification to reduced cardiovascular events.

Related Experiment Videos

  • Combination therapies (statin/fibrate, statin/niacin, statin/bile acid resin, statin/ezetimibe) show significant lipid profile changes with acceptable safety.
  • Limited long-term trials of combination therapy are promising for clinical outcomes.

    • Conclusions:

    • Combining lipid-altering agents enhances lipoprotein improvements.
    • This approach has the potential to further reduce cardiovascular events beyond monotherapy.