Combination hypolipidemic therapy

Česká verzia

Authors: M. Vráblík
Authors place of work: Centrum preventivní kardiologie, 3. interní klinika 1. LF UK a VFN v Praze
Published in the journal: Kardiol Rev Int Med 2014, 16(6): 458-463
Category: Cardiology Review

Summary

Co-administration of more than one drug targeting cardiovascular risk by impacting on serum lipoprotein metabolism is used much less than combinations in the treatment of arterial hypertension or type 2 diabetes. The most commonly used lipid lowering drugs are statins, which may combined with ezetimibe or bile acid sequestrants when a more significant decrease of LDL-cholesterol is required. In mixed dyslipidemia, particularly in the context of type 2 diabetes, statins may be combined with fibrates, or even with pharmacological doses of omega-3 fatty acids. On the contrary, the results of the latest clinical trials have shown that niacin has lost its position in the treatment of dyslipidemia. The results of clinical trials with brand-new molecules used in the treatment of dyslipidemia hold great promise – in particular, monoclonal antibodies against PCSK9 seem to offer unprecedented possibilities of impacting on lipid metabolism. However, they will also be present mainly within the combination lipid lowering regimens. Triple- and multiple-lipid lowering combos are not supported by clinical trial data, but they might be used in individual cases for the benefit of our patients.

Keywords:
cardiovascular risk – dyslipidemia – lipid lowering combination – statins – fibrates – ezetimibe – resins – PCSK9 inhibitors

Zdroje

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