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Scant Evidence of Combination Lipid Therapy Benefit Found

Any benefits over high-dose statin monotherapy yet to be clearly defined

THURSDAY, Sept. 3 (HealthDay News) -- There is scant evidence to support the use of combination lipid-lowering therapies over high-dose statin monotherapy to treat patients at high risk of coronary disease, according to a study published online Sept. 1 in the Annals of Internal Medicine.

Mukul Sharma, M.D., of the Ottawa Hospital, and colleagues conducted a review of 102 studies to compare the outcomes of high-dose statin monotherapy with combination therapy to treat patients at high risk for coronary disease.

The researchers found that, of all the trials reviewed, none compared the impact of the two therapeutic approaches on incidence of myocardial infarction, stroke, or revascularization procedures. Three trials showed weak evidence that statin-ezetimibe and statin-fibrate combinations did not reduce mortality more than high-dose statin monotherapy.

"The available evidence supporting the use of combination therapies over high-dose statin monotherapy, including long-term clinical benefits and reduced risks, is insufficient to guide many clinical decisions," the authors write. "The effectiveness of statins in reducing vascular events suggests that the benefits of additional therapies need to be clearly defined along with attendant risks and cost before advocating widespread use of combination treatment."

Two authors reported financial support from the pharmaceutical industry.

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