Some Statin Combination Therapy Better at Lowering LDL Than Statin Intensification, but Effects on Clinical Outcomes Unknown

A research review from AHRQ finds that to reduce abnormal lipoprotein levels and prevent coronary heart disease, a combination of statin with ezetimibe or bile acid sequestrant lowered low-density lipoprotein (LDL-c) better than intensification of statin monotherapy. However, evidence for clinical outcomes (mortality, acute coronary events, and revascularization procedures) was insufficient across all potency comparisons for all combination therapy regimens. The American Heart Association has estimated that cardiovascular disease affects 83.6 million individuals, contributes to 32.3 percent of deaths, and is a leading cause of disability. Findings from the report, “Combination Therapy Versus Intensification of Statin Monotherapy: An Update,” were published February 11 in Annals of Internal Medicine. The report said more research, particularly in high-risk coronary heart disease populations and populations with greater burden of cardiovascular disease, is needed to evaluate long-term clinical benefits and harms.