Assessment of lipid-lowering treatment in France--the CEPHEUS study

Most evidence-based practice guidelines identify low-density lipoprotein cholesterol (LDL-C) as the primary target of cholesterol-lowering therapy; the optimal LDL-C concentration is based on the patient's individual risk level. The aim of this study was to determine the proportion of patients on lipid-lowering drugs who reach the LDL-C goals recommended in guidelines.

The CEPHEUS study was conducted in eight European countries in patients, who had been treated with lipid-lowering drugs for at least three months, with no dose adjustment for a minimum of six weeks. In France, throughout 2006, 560 general practitioners enrolled 2222 patients into the study, 1966 of whom gave a fasting blood sample. Lipid and glucose parameters were measured centrally.

Patients had been on treatment for a mean of 5.5+/-5.7 years. Most patients (90.4%) received a single lipid-lowering drug; 84.9% were treated with statins, and the second most frequently used lipid-lowering drugs were fibrates (13.7%). Among the treated subjects, 50% had LDL-C values>3.0 mmol/L, 30% had triglyceride values>1.7 mmol/L and 10% had HDL cholesterol values<1.1 mmol/L. In high-risk patients, as defined by French guidelines, over 55% were above the recommended goal of 2.6 mmol/L. In the subgroup of high-risk patients who did not reach the goals, the LDL-C values were 0.7-1.4 mmol/L over the recommended concentration.

The results of this survey highlight the suboptimal management of hypercholesterolaemia in France, particularly in the high-risk population, in whom the percentage who achieved the LDL-C goals was the lowest.