Cholesterol-lowering therapy with statins effectively prevents cardiovascular disease, but treatment with statins does not guarantee that cholesterol targets are reached. In cases where intensive lipid-lowering is needed, physicians sometimes combine statins with other lipid-modifying medications. However, according to a review published online before print September 1, 2009 in Annals of Internal Medicine, limited evidence suggests that combinations of lipid-lowering agents do not improve clinical outcomes more than high-dose statins alone.
Researchers from the University of Ottawa in Ontario, Canada and their colleagues reviewed 102 studies to compare the benefits and harms of high-dose statins versus combination lipid-lowering therapy in adults at high risk for coronary artery disease. They found very-low-strength evidence that combination lipid-lowering therapy did not reduce mortality more than high-dose statins, though two trials did show that combination therapy was more likely to attain cholesterol-lowering goals.
Overall, the researchers found no benefit for combination lipid-lowering therapy over high-dose statins for mortality, heart attack, stroke, or the need for a revascularization procedure. However, a limitation of the review was that most of the studies reviewed were short. Further research is needed to see if there is a difference in clinical outcomes between combination lipid-lower therapy and high-dose statins in the long term.
Source:
Ann Intern Med. Published online before print September 1, 2009.
Pitavastatin, which will be marketed as Livalo®, is the newest statin therapy to be introduced for cholesterol-lowering. The FDA’s approval of pitavastatin is based upon evidence from five Phase III trials demonstrating its efficacy in lowering low density lipoprotein (LDL) cholesterol in elderly patients, diabetics, and patients at higher cardiovascular risk.
Livalo is expected to launch in the U.S. in early 2010, and this cholesterol-lowering drug will be available in three dosages.
Source:
U.S. Food and Drug Administration website, accessed August 5, 2009.
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