Strategies for the use of nonstatin therapies

Angela Pirillo, Giuseppe D. Norata, Alberico L. Catapano

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose of review Dyslipidaemias are a major risk factor for cardiovascular disease (CVD); in particular, high levels of low-density lipoprotein cholesterol (LDL-C) have been associated to a higher cardiovascular risk. Reducing LDL-C levels decreases the risk of coronary heart disease (CHD), and the greater the LDL-C reduction, the greater the decrease in cardiovascular risk. Although statins represent the first line lipid-lowering therapy, many patients do not reach the recommended goals or exhibit adverse side effects leading to therapy discontinuation; in addition, a significant percentage of statin-treated patients continue to experience cardiovascular events even in the presence of well controlled LDL-C levels, because of alterations in other lipid/lipoprotein classes, including triglycerides and high-density lipoprotein cholesterol. Recent findings These conditions require further therapeutic interventions to achieve the recommended lipid goals. Several drugs have been developed to address these needs. Recent studies have shown that the association of ezetimibe with rosuvastatin or atorvastatin results in a better hypolipidaemic effect; in addition to this, PCSK9 inhibitors significantly reduce LDL-C levels and cardiovascular events. Summary For patients who are intolerant to statins or not able to reach the recommended LDL-C levels, despite maximal tolerated dose of statin, or exhibiting additional lipid alterations, several drugs are available that can be used either in monotherapy or on top of the maximally tolerated dose of statins.

Original languageEnglish
Pages (from-to)458-464
Number of pages7
JournalCurrent Opinion in Lipidology
Volume28
Issue number6
DOIs
Publication statusPublished - Dec 1 2017
Externally publishedYes

Keywords

  • dyslipidaemias
  • ezetimibe
  • hypercholesterolaemia
  • LDL-C
  • PCSK9 inhibitors
  • statin intolerance
  • triglycerides

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Molecular Biology
  • Genetics
  • Nutrition and Dietetics
  • Cardiology and Cardiovascular Medicine
  • Cell Biology

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