Fixed Combination for the Treatment of Dyslipidaemia

Curr Atheroscler Rep. 2023 Oct;25(10):691-699. doi: 10.1007/s11883-023-01142-x. Epub 2023 Sep 16.

Abstract

Purpose of review: It is clear from epidemiological studies that patients at high and very-high risk of atherosclerotic cardiovascular diseases (ASCVD) risk do not reach lipid guideline-recommended targets. Thus, fixed-dose combinations of statins/ezetimibe, bempedoic acid/ezetimibe and statins/fibrates may represent a further armamentarium in the field of lipid-lowering approaches in these individuals.

Recent findings: The combination therapy of moderate-intensity statin with ezetimibe is not inferior to high-intensity statin monotherapy in reducing cardiovascular outcomes. Drug discontinuation or dose reduction is inferior with fixed-dose combination. The fixed-dose combination of bempedoic acid with ezetimibe is superior to bempedoic acid in monotherapy in lowering LDL-C and in reducing high-sensitivity C-reactive protein concentrations. The combination fenofibrate with atorvastatin is superior to monotherapies in lowering triglycerides. Lipid-lowering fixed-dose combinations may guarantee a higher therapy adherence, representing a better approach to control plasma lipids and thus ameliorate ASCVD burden. Additional studies will define the advantages on cardiovascular outcomes in high and very high-risk patients.

Keywords: Bempedoic acid; Combinations; Ezetimibe; Fenofibrate; Polypill; Statins.

Publication types

  • Review

MeSH terms

  • Anticholesteremic Agents* / therapeutic use
  • Atherosclerosis* / drug therapy
  • Cholesterol, LDL
  • Drug Therapy, Combination
  • Dyslipidemias* / drug therapy
  • Ezetimibe / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
  • Treatment Outcome

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • 8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid
  • Cholesterol, LDL
  • Ezetimibe
  • Anticholesteremic Agents