Combination therapy for the treatment of dyslipidemia and reduction of cardiovascular
risk has been demonstrated to beneficially modify the lipid profile in multiple randomized
clinical trials. As reported in the updated National Cholesterol Education Program
Adult Treatment Panel III guidelines, low-density lipoprotein (LDL) cholesterol remains
the primary treatment target, although the comprehensive management of dyslipidemia
in high-risk patients includes the modification of secondary lipid parameters such
as triglycerides, high-density lipoprotein cholesterol, and non–high-density lipoprotein
cholesterol. Although statin therapy is the standard intervention for lowering LDL
cholesterol, combination therapy has demonstrated added benefits on secondary lipid
parameters and enhances statin-mediated reductions in LDL cholesterol. The benefits
of modifying these secondary targets on all-cause or cardiovascular event–related
mortality are currently under investigation in several clinical trials. Prescription
omega-3 fatty acid (Lovaza) is a formulation of 2 highly purified omega-3-acid ethyl
esters, eicosapentaenoic acid and docosahexaenoic acid. The recently completed Combination
of Prescription Omega-3 With Simvastatin (COMBOS) study confirmed that prescription
omega-3 fatty acid administered in combination with simvastatin achieves statistically
significant improvements across a range of lipid indicators beyond the LDL primary
target, including triglycerides, non–high-density lipoprotein cholesterol, and lipoprotein
particle size. In conclusion, several classes of drugs, including omega-3 fatty acids,
can be used in combination with statins to achieve more global improvements in lipid
profiles.
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Article info
Publication history
Published online: August 04, 2008
Accepted:
May 20,
2008
Received in revised form:
May 20,
2008
Received:
April 7,
2008
Footnotes
This report was funded in part by Reliant Pharmaceuticals, Liberty Corner, New Jersey, a subsidiary of GlaxoSmithKline, Beecham, North Carolina.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
