Background and aims: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients. Methods: Evidence-based review. Results: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus. Conclusions: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.

Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients : A statement from a European Atherosclerosis Society Task Force / M. Averna, M. Banach, E. Bruckert, H. Drexel, M. Farnier, D. Gaita, P. Magni, W. Marz, L. Masana, A. Mello e Silva, Z. Reiner, E. Ros, M. Vrablik, A. Zambon, J.L. Zamorano, J.K. Stock, L.S. Tokgozoglu, A.L. Catapano. - In: ATHEROSCLEROSIS. - ISSN 0021-9150. - 325(2021 May), pp. 99-109. [10.1016/j.atherosclerosis.2021.03.039]

Practical guidance for combination lipid-modifying therapy in high- and very-high-risk patients : A statement from a European Atherosclerosis Society Task Force

P. Magni;A.L. Catapano
Ultimo
2021

Abstract

Background and aims: This European Atherosclerosis Society (EAS) Task Force provides practical guidance for combination therapy for elevated low-density lipoprotein cholesterol (LDL-C) and/or triglycerides (TG) in high-risk and very-high-risk patients. Methods: Evidence-based review. Results: Statin-ezetimibe combination treatment is the first choice for managing elevated LDL-C and should be given upfront in very-high-risk patients with high LDL-C unlikely to reach goal with a statin, and in primary prevention familial hypercholesterolaemia patients. A proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor may be added if LDL-C levels remain high. In high and very-high-risk patients with mild to moderately elevated TG levels (>2.3 and < 5.6 mmol/L [>200 and < 500 mg/dL) on a statin, treatment with either a fibrate or high-dose omega-3 fatty acids (icosapent ethyl) may be considered, weighing the benefit versus risks. Combination with fenofibrate may be considered for both macro- and microvascular benefits in patients with type 2 diabetes mellitus. Conclusions: This guidance aims to improve real-world use of guideline-recommended combination lipid modifying treatment.
2019 ESC/EAS Dyslipidaemia Guidelines; Combination treatment; High-risk; LDL cholesterol; Lipid goals; Triglycerides
Settore MED/04 - Patologia Generale
Settore BIO/14 - Farmacologia
Settore MED/13 - Endocrinologia
Article (author)
File in questo prodotto:
File Dimensione Formato  
1-s2.0-S0021915021001623-main.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.08 MB
Formato Adobe PDF
1.08 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
1-s2.0-S0021915021001623-main.pdf

accesso riservato

Tipologia: Publisher's version/PDF
Dimensione 1.42 MB
Formato Adobe PDF
1.42 MB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Caricamento pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2434/843397
Citazioni
  • ???jsp.display-item.citation.pmc??? 19
  • Scopus 35
  • ???jsp.display-item.citation.isi??? 29
social impact