1. [STEP-RCV Project - A scientific expert panel for patients at high and very high cardiovascular risk: how to streamline lipid-lowering therapy].
- Author
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Colivicchi F, Arca M, Di Fusco SA, Pirillo A, and Catapano AL
- Subjects
- Humans, Cholesterol, LDL, Risk Factors, Ezetimibe therapeutic use, Proprotein Convertase 9, Heart Disease Risk Factors, Cardiovascular Diseases prevention & control, Cardiovascular Diseases chemically induced, Hypercholesterolemia complications, Hypercholesterolemia drug therapy, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Anticholesteremic Agents therapeutic use
- Abstract
Over the last decade, several innovative therapeutic options have been developed and marketed for the management of hypercholesterolemia. However, the impossibility of a contextual update of international guidelines and the limits imposed by national regulatory authorities do not allow the use of these treatments in many patients, in particular in those at higher cardiovascular risk. Real-world studies show that the use of lipid-lowering therapies is inadequate even among patients at higher cardiovascular risk, with only 20% achieving recommended low-density lipoprotein cholesterol (LDL-C) levels and the use of combination therapies implemented in only 24% of patients. This review aims to highlight the benefits of an approach based on combination therapy and to propose a therapeutic algorithm that includes oral combination therapy, where necessary also in triple association (statin, ezetimibe and bempedoic acid), as an initial approach based on the most favorable cost-effectiveness ratio for patients at higher cardiovascular risk and the use of injectable anti-proprotein convertase subtilisin/kexin 9 therapies if the recommended LDL-C goal is not achieved.
- Published
- 2024
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