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Rationale for combination therapy with statin drugs in the treatment of dyslipidemia

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Abstract

Although statin therapy is a mainstay of lipid treatment, complementary effects of other cholesterol-lowering therapies modify the lipid panel and other aspects of coronary disease risk. These other therapies lower low-density lipoprotein cholesterol and triglycerides and/or raise high-density lipoprotein cholesterol, improve diabetic control, and modify other cardiovascular risks. Historically, combination therapy has been reserved for the small minority of patients with severe dyslipidemia, due to perceived risk. More recently, however, it has been recognized that the potential complications of this combination are far outweighed by the clinical benefits that are possible.

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References and Recommended Reading

  1. Grundy SM, Cleeman JI, Merz CN, et al.: Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Arterioscler Thromb Vasc Biol 2004, 24:e149-e161.

    Article  PubMed  CAS  Google Scholar 

  2. Jeu L, Cheng JW: Pharmacology and therapeutics of ezetimibe (SCH 58235), a cholesterol-absorption inhibitor. Clin Ther 2003, 25:2352–2387.

    Article  PubMed  CAS  Google Scholar 

  3. Gagne C, Bays HE, Weiss SR, et al.: Efficacy and safety of ezetimibe added to ongoing statin therapy for treatment of patients with primary hypercholesterolemia. Am J Cardiol 2002, 90:1084–1091.

    Article  PubMed  CAS  Google Scholar 

  4. Kosoglou T, Statkevich P, Yang B, et al.: Pharmacodynamic interaction between ezetimibe and rosuvastatin. Curr Med Res Opin 2004, 20:1185–1195.

    Article  PubMed  CAS  Google Scholar 

  5. Schuster H, Fox JC: Investigating cardiovascular risk reduction the Rosuvastatin GALAXY Programme. Expert Opin Pharmacother 2004, 5:1187–1200.

    PubMed  CAS  Google Scholar 

  6. Ballantyne CM, Blazing MA, King TR, et al.: Efficacy and safety of ezetimibe co-administered with simvastatin compared with atorvastatin in adults with hypercholesterolemia. Am J Cardiol 2004, 93:1487–1494.

    Article  PubMed  CAS  Google Scholar 

  7. Ballantyne CM, Houri J, Notarbartolo A, et al.: Effect of ezetimibe coadministered with atorvastatin in 628 patients with primary hypercholesterolemia: a prospective, randomized, double-blind trial. Circulation 2003, 107:2409–2415.

    Article  PubMed  CAS  Google Scholar 

  8. Sager PT, Melani L, Lipka L, et al.: Effect of coadministration of ezetimibe and simvastatin on high-sensitivity C-reactive protein. Am J Cardiol 2003, 92:1414–1418.

    Article  PubMed  CAS  Google Scholar 

  9. Ballantyne CM, Lipka LJ, Sager PT, et al.: Long-term safety and tolerability profile of ezetimibe and atorvastatin coadministration therapy in patients with primary hypercholesterolaemia. Int J Clin Pract 2004, 58:653–658.

    Article  PubMed  CAS  Google Scholar 

  10. Fux R, Morike K, Gundel UF, et al.: Ezetimibe and statin-associated myopathy. Ann Intern Med 2004, 140:671–672.

    PubMed  Google Scholar 

  11. Wiegman A, Hutten BA, de Groot E, et al.: Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA 2004, 292:331–337.

    Article  PubMed  CAS  Google Scholar 

  12. McCrindle BW, Helden E, Cullen-Dean G, Conner WT. A randomized crossover trial of combination pharmacologic therapy in children with familial hyperlipidemia. Pediatr Res 2002, 51:715–721.

    PubMed  CAS  Google Scholar 

  13. Bays H, Dujovne C: Colesevelam HCl: a non-systemic lipid-altering drug. Expert Opin Pharmacother 2003, 4:779–790.

    PubMed  Google Scholar 

  14. Wolfe ML, Vartanian SF, Ross JL, et al.: Safety and effectiveness of Niaspan when added sequentially to a statin for treatment of dyslipidemia. Am J Cardiol 2001, 87:476–479, A7.

    Article  PubMed  CAS  Google Scholar 

  15. Kane JP, Malloy MJ, Ports TA, et al.: Regression of coronary atherosclerosis during treatment of familial hypercholesterolemia with combined drug regimens. JAMA 1990, 264:3007–3012.

    Article  PubMed  CAS  Google Scholar 

  16. Brown BG, Zhao XQ, Chait A, et al.: Simvastatin and niacin, antioxidant vitamins, or the combination for the prevention of coronary disease. N Engl J Med 2001, 345:1583–1592.

    Article  PubMed  CAS  Google Scholar 

  17. Zhao XQ, Morse JS, Dowdy AA, et al.: Safety and tolerability of simvastatin plus niacin in patients with coronary artery disease and low high-density lipoprotein cholesterol (The HDL Atherosclerosis Treatment Study). Am J Cardiol 2004, 93:307–312.

    Article  PubMed  CAS  Google Scholar 

  18. Jones PH, Davidson MH, Stein EA, et al.: Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol 2003, 92:152–160.

    Article  PubMed  CAS  Google Scholar 

  19. Capuzzi DM, Morgan JM, Weiss RJ, et al.: Beneficial effects of rosuvastatin alone and in combination with extended-release niacin in patients with a combined hyperlipidemia and low high-density lipoprotein cholesterol levels. Am J Cardiol 2003, 91:1304–1310.

    Article  PubMed  CAS  Google Scholar 

  20. Frick MH, Elo O, Haapa K, et al.: Helsinki Heart Study: primary-prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med 1987, 317:1237–1245.

    Article  PubMed  CAS  Google Scholar 

  21. Rubins HB, Robins SJ, Collins D, et al.: Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Engl J Med 1999, 341:410–418.

    Article  PubMed  CAS  Google Scholar 

  22. Prueksaritanont T, Tang C, Qiu Y, et al.: Effects of fibrates on metabolism of statins in human hepatocytes. Drug Metab Dispos 2002, 30:1280–1287.

    Article  PubMed  CAS  Google Scholar 

  23. Pan WJ, Gustavson LE, Achari R, et al.: Lack of a clinically significant pharmacokinetic interaction between fenofibrate and pravastatin in healthy volunteers. J Clin Pharmacol 2000, 40:316–323.

    Article  PubMed  CAS  Google Scholar 

  24. Ellen RL, McPherson R: Long-term efficacy and safety of fenofibrate and a statin in the treatment of combined hyperlipidemia. Am J Cardiol 1998, 81:60B-65B.

    Article  PubMed  CAS  Google Scholar 

  25. Corbelli JC, Bullano MF, Willey VJ, et al.: Effects of gemfibrozil conversion to fenofibrate on lipids in patients on statin therapy. Am J Cardiol 2002, 90:1388–1391.

    Article  PubMed  CAS  Google Scholar 

  26. Lipids in Diabetes Study website. http://www.dtu.ox.ac.uk/index.html?maindoc=/lds/index.html. Accessed on September 1, 2004.

  27. Klosiewicz-Latoszek L, Szostak WB, Grzybowska B, et al.: Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia. Kardiol Pol 2004, 60:567–577.

    PubMed  Google Scholar 

  28. Yee A, Majumdar SR, Simpson SH, et al.: Statin use in Type 2 diabetes mellitus is associated with a delay in starting insulin. Diabetes Med 2004, 21:962–967.

    Article  CAS  Google Scholar 

  29. King AB, Armstrong DU: Lipid response to pioglitazone in diabetic patients: clinical observations from a retrospective chart review. Diabetes Technol Ther 2002, 4:145–151.

    Article  PubMed  CAS  Google Scholar 

  30. Brousseau ME, Schaefer EJ, Wolfe ML, et al.: Effects of an inhibitor of cholesteryl ester transfer protein on HDL cholesterol. N Engl J Med 2004, 350:1505–1515.

    Article  PubMed  CAS  Google Scholar 

  31. Masana L, Villoria J, Sust M, et al.: Treatment of type IIb familial combined hyperlipidemia with the combination pravastatinpiperazine sultosilate. Eur J Pharmacol 2004, 496:205–212.

    Article  PubMed  CAS  Google Scholar 

  32. Wald NJ, Law MR: A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003, 326:1419–1420.

    Article  PubMed  CAS  Google Scholar 

  33. Flack JH, Neutel J: Efficacy and safety of atorvastatin plus amlodipine versus either agent alone in patients with concomitant dyslipidemia and hypertension: the AVALON study. J Hypertens 2004, 22(Suppl I):12S.

    Google Scholar 

  34. Hennekens CH, Sacks FM, Tonkin A, et al.: Additive benefits of pravastatin and aspirin to decrease risks of cardiovascular disease: randomized and observational comparisons of secondary prevention trials and their meta analyses. Arch Intern Med 2004, 164:40–44.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of General Internal Medicine/Cardiology, David Geffen/UCLA School of Medicine, 200 UCLA Medical Plaza, Suite 370-8, 90095, Los Angeles, CA, USA

    Benjamin J. Ansell MD

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  1. Benjamin J. Ansell MD
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Ansell, B.J. Rationale for combination therapy with statin drugs in the treatment of dyslipidemia. Curr Atheroscler Rep 7, 29–33 (2005). https://doi.org/10.1007/s11883-005-0072-7

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  • DOI: https://doi.org/10.1007/s11883-005-0072-7

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