A latest study from the Ottawa Hospital Research Institute and the University of Ottawa claimed that there is not much information to support the extensive use of so-called ‘combination therapies’ to lower cholesterol.
Statins are supposed to be the most broadly prescribed class of cholesterol lowering drugs. However it appears that they are increasingly being used at a higher dose or in an assortment with other kinds of drugs mainly because people may not react to the standard dose of statin.
A systematic review was conducted to find out how much evidence supports the use of these combination therapies versus high dose statin therapy. Ottawa stroke specialist Dr. Mukul Sharma and his colleagues examined the review. They checked about 102 studies that tested combination therapies concerning ezetimibe, niacin, bile acid sequestrants and omega-3 fatty acids.
“Our review shows that so far, there is not enough evidence to support the widespread use of combination therapies over high dose statin therapy. Thus, for most patients who don’t respond to a low dose of statin, it would make sense to try a higher dose of statin before trying a combination therapy. If the high dose statin does not work or is not well tolerated, or if there are other special circumstances, a combination therapy may be a good option, but until more research is done, this is not recommended for most patients,” commented Dr. Mukul Sharma, Medical Director of the Regional Stroke Centre at The Ottawa Hospital, a Clinical Investigator at the Ottawa Hospital Research Institute, Assistant Professor of Medicine at the University of Ottawa and Deputy Director of the Canadian Stroke Network.
Dr Sharma observed that it may particularly be vital to have this type of independent analysis of drugs which are heavily promoted. Approximately every year, 35 million Canadians and Americans are supposedly prescribed cholesterol lowering drugs. The risk of heart attack, stroke and other cardiovascular conditions may be reduced due to lower cholesterols.
This study was published in the online edition of Annals of Internal Medicine.