+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Combination regimens with statin, niacin, and intestinally active LDL-lowering drugs: alternatives to high-dose statin therapy?



Combination regimens with statin, niacin, and intestinally active LDL-lowering drugs: alternatives to high-dose statin therapy?



Current Opinion in Lipidology 21(4): 372-377



To summarize recent studies on combination regimens that employ a statin with added niacin, ezetimibe, and/or bile acid sequestrants, and to understand the implications of these studies for clinical practice. Combinations of statin, niacin, and/or intestinally active LDL-lowering drug have demonstrated safety and favorable effects on plasma low and high-density lipoproteins. Niacin and bile acid sequestrants appear to exert beneficial effects on atherosclerotic lesions, whereas results with ezetimibe are uncertain. Moreover, the use of niacin and bile acid sequestrants is supported by clinical outcome results from large monotherapy trials and small combination therapy trials. Three large randomized trials currently are evaluating clinical outcomes with the addition of niacin or ezetimibe to statin treatment. Until the results of ongoing trials are known, it is reasonable to favor the use of niacin and bile acid sequestrants in combination with statins, based on safety and efficacy with regard to effects on lipoproteins, atherosclerotic lesions, and, to a limited extent, clinical outcomes. The effect of ezetimibe on carotid atherosclerosis is indeterminate, but ezetimibe can be reasonably added to statin therapy as a secondary option for LDL-lowering.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 052175402

Download citation: RISBibTeXText

PMID: 20625257

DOI: 10.1097/mol.0b013e32833c1f16


Related references

Tolerability of statin-fibrate and statin-niacin combination therapy in dyslipidemic patients at high risk for cardiovascular events. American Journal of Cardiology 89(4): 390-394, February 15, 2002

Tu-W27:4 Comparative lipid effects of combination therapy with a statin and extended-release niacin versus statin plus ezetimibe versus a statin alone. Atherosclerosis Suppl.s 7(3): 174-175, 2006

Comparative effects on lipid levels of combination therapy with a statin and extended-release niacin or ezetimibe versus a statin alone (the COMPELL study). Atherosclerosis 192(2): 432-437, 2007

Comparison of effectiveness of statin monotherapy versus statin and niacin combination therapy in primary prevention and effects on calcified plaque burden. American Journal of Cardiology 91(3): 348-351, 2003

The Effect of Ezetimibe/Statin Combination and High-Dose Statin Therapy on Thyroid Autoimmunity in Women with Hashimoto's Thyroiditis and Cardiovascular Disease: A Pilot Study. Experimental and Clinical Endocrinology and Diabetes 124(9): 577-581, 2016

Pretreatment with high-dose statin, but not low-dose statin, ezetimibe, or the combination of low-dose statin and ezetimibe, limits infarct size in the rat. Journal of Cardiovascular Pharmacology and Therapeutics 13(1): 72-79, 2008

Niacin, fenofibrates increase benefits for statin users. These HDL- raising, triglyceride-lowering drugs beat out the use of additional LDL-lowering drugs. Dukemedicine Healthnews 16(8): 1-2, 2010

Efficacy and safety of alirocumab 150mg every 4 weeks in hypercholesterolemic patients on non-statin lipid-lowering therapy or lowest strength dose of statin: ODYSSEY NIPPON. Journal of Cardiology 2018, 2018

Alternative drug therapy of severe hypercholesterolemia: fibrate-statin combination or increased dose of statin?. Atherosclerosis 109(1-2): 256, 1994

High-dose statin monotherapy versus low-dose statin/ezetimibe combination on fasting and postprandial lipids and endothelial function in obese patients with the metabolic syndrome: The PANACEA study. Atherosclerosis 227(1): 118-124, 2013

A comparison of the efficacy of combined ezetimibe and statin therapy with doubling of statin dose in patients with remnant lipoproteinemia on previous statin therapy. Journal of Cardiology 60(1): 12-17, 2013

Comparison of Low-Dose Statin Versus Low-Dose Statin + Armolipid Plus in High-Intensity Statin-Intolerant Patients With a Previous Coronary Event and Percutaneous Coronary Intervention (ADHERENCE Trial). American Journal of Cardiology 120(6): 893-897, 2017

Efficacy and safety of extended-release niacin/laropiprant plus statin vs. doubling the dose of statin in patients with primary hypercholesterolaemia or mixed dyslipidaemia. International Journal of Clinical Practice 64(6): 727-738, 2011

Reduction in recurrent cardiovascular events with intensive lipid-lowering statin therapy compared with moderate lipid-lowering statin therapy after acute coronary syndromes from the PROVE IT-TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22) trial. Journal of the American College of Cardiology 54(25): 2358-2362, 2010

Effect of very-low-dose niacin on high-density lipoprotein in patients undergoing long-term statin therapy. American Heart Journal 143(3): 514-518, 2002