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Letters |4 November 2014

Effectiveness of Combination Therapy With Statin and Another Lipid-Modifying Agent Compared With Intensified Statin Monotherapy

Tetsuro Tsujimoto, MD; Ritsuko Yamamoto-Honda, MD, PhD

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TO THE EDITOR:
Gudzune and colleagues (1) have reported a study on the effect of combination therapy with statin and other lipid-modifying agents, such as bile acid sequestrants and ezetimibe. This study had several important findings about combination therapy but also had several substantial problems, and the results should be carefully interpreted from various perspectives. It, indeed, revealed that combination therapy significantly decreased low-density lipoprotein cholesterol levels compared with mid- to high-intensity statin monotherapy. However, this finding does not mean that combination therapy is better than statin monotherapy.
Combination therapy may not be superior to high-intensity statin monotherapy at improving the outcomes of deaths and cardiovascular events (2). Whether combination therapy could achieve better targets for low-density lipoprotein cholesterol than statin monotherapy also is unclear. Moreover, low-intensity statins in combination therapy may have fewer pleiotropic effects than high-intensity statins (3).
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Tsujimoto T, Yamamoto-Honda R. Effectiveness of Combination Therapy With Statin and Another Lipid-Modifying Agent Compared With Intensified Statin Monotherapy. Ann Intern Med. ;161:678–679. doi: 10.7326/L14-5021-2

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Published: Ann Intern Med. 2014;161(9):678-679.

DOI: 10.7326/L14-5021-2

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