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Reaching cholesterol targets: Which medicine to use?
In the original version of this article, the ethnicity of the patient was omitted. Joel is of Pacific descent, which affects how the switch from atorvastatin 40mg to rosuvastatin should be managed.
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Pharmacotherapy
Reaching cholesterol targets: Which medicine to use?
Wednesday 22 May 2024, 12:15 AM
Joel was faced with three options for lowering his cholesterol and managing his cardiovascular risk [Image: Akriti Singh on Unsplash]
Pharmacist prescriber Linda Bryant runs through the options available to a patient on statin therapy that has been ineffective at reducing his cardiovascular risk
Key points, The adverse effects of statins are dose dependent, so doubling the dose is not always appropriate when additional lipid lowering is required.
Adding, Pract Green w Pale Yellow
References
1. Ministry of Health. Cardiovascular Disease Risk Assessment and Management for Primary Care. Wellington, NZ: Ministry of Health; 2018.
2. Lee SJ, Joo JH, Park S, et al. Combination therapy with moderate-intensity atorvastatin and ezetimibe versus high-intensity atorvastatin monotherapy in patients treated with percutaneous coronary intervention in practice: assessing RACING generalizability. Eur Heart J Cardiovasc Pharmacother 2023; 10 November online.
3. Yu M, Liang C, Kong Q, et al. Efficacy of combination therapy with ezetimibe and statins versus a double dose of statin monotherapy in participants with hypercholesterolemia: a meta-analysis of literature. Lipids Health Dis 2020;19(1):1.
4. Lee B, Hong SJ, Rha SW, et al. Moderate-intensity statin plus ezetimibe vs high-intensity statin according to baseline LDL-C in the treatment of atherosclerotic cardiovascular disease: A post-hoc analysis of the RACING randomized trial. Atherosclerosis 2023;386:117373.
5. Reddy V, Allison J, Mounsey A. Is there benefit to adding ezetimibe to a statin for the secondary prevention of CVD? J Fam Pract 2023;72(5):227–29.
6. Alrajeh K, AlAzzeh O, Roman Y. The frequency of major ABCG2, SLCO1B1 and CYP2C9 variants in Asian, Native Hawaiian and Pacific Islander women subgroups: implications for personalized statins dosing. Pharmacogenomics 2023;24(7):381–98.
7. Lee YJ, Hong SJ, Kang WC, et al. Rosuvastatin versus atorvastatin treatment in adults with coronary artery disease: secondary analysis of the randomised LODESTAR trial. BMJ 2023;383:e075837.
8. Shin JI, Fine DM, Sang Y, et al. Association of rosuvastatin use with risk of hematuria and proteinuria. J Am Soc Nephrol 2022;33(9):1767–77.
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