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REFLECTIONS dae mia
Dyslipidaemia Global Newsletter #2
aim ead
Dyslipi

A simple treatment algorithm for patients with very high-risk of atherosclerotic CVD emphasizes the importance of starting with Dyslipi

combination therapy as first-line treatment in this patient group. In patients with very high CVD risk, starting a statin + ezetimibe (or

for those that are statin intolerant, ezetimibe + bempedoic acid or ezetimibe + PCSK9 targeted therapy) is recommended with the

aim of reducing LDL-C levels by >50% (and LDL-C <1.4 mmol/L). For those at extremely high-risk of CVD, initiation of triple therapy

should be considered, such as a statin + ezetimibe + PCSK9 targeted therapy. Fixed-dose combination tables lower LDL-C more

efficiently compared to two separate tables and could therefore be considered.

The authors suggest that the ‘wait and watch paradigm’ on high-intensity CLINICAL PEARLS FROM THE FACULTY
statin treatment should be replaced with first-line combination therapy as
the basic standard of care for patients at very high- and extremely high-risk
of CVD.

WATCH
PROF. SANDIN’S
THOUGHTS ON THE
CLINICAL APPLICATION OF
THIS RECOMMENDATION
AND WHETHER IT IS
ROUTINELY FOLLOWED IN
REAL-WORLD PRACTICE
CLICK HERE
FOR THE LINK TO FULL
ARTICLE

Adherence to lipid-lowering treatment by single-pill combination of statin and
ezetimibe.

Rea F, et al. Adv Ther. 2021;38(10):5270-5285.

It has been demonstrated that a simplified CV drug treatment being highly adherent, irrespective of age, sex, and clinical
leads to better treatment adherence and single-pill combinations profile. The risk of treatment discontinuation was also lower
are now recommended by several clinical guidelines. In this in the single-pill group (31.3%) compared to the two-pill
real-world study, the authors aimed to measure the adherence combination group (54.5%).
level of patients newly treated with statins, comparing those
starting a two-pill or a single-pill combination of statin and The risk of CV events was also shown to be decreased by
ezetimibe in a cohort of 2,129 matched couples. 55% in patients with high adherence compared to those with
low adherence. There was no difference in outcomes between
Compared to those prescribed a two-pill combination, those single-pill and two-pill treatment strategies when data were
prescribed a single-pill combination had 87% greater odds of adjusted for adherence, suggesting that adherence plays the

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