Therapies Used in Inadequate Responders to Statins
An expert discusses how nonstatin therapies serve as essential tools when patients can’t tolerate statins or need additional LDL cholesterol-lowering agents.
These include ezetimibe, a cholesterol absorption inhibitor, bempedoic acid, a liver-specific prodrug, and PCSK9-interfering therapies, both injectable monoclonal antibodies and inclisiran.
Treatment selection is based on patient comorbidities, cardiovascular risk level, and specific LDL cholesterol targets.
Clinical Presentation and Available Nonstatin Therapies
When patients cannot tolerate adequate statin therapy or require additional LDL cholesterol reduction, several nonstatin options are available.
Ezetimibe serves as the foundational add-on therapy, functioning as a cholesterol absorption inhibitor that blocks dietary cholesterol uptake in the intestine and prevents bile acid reabsorption in the liver, achieving approximately 20% LDL cholesterol reduction.
Ezetimibe is the foundational add-on therapy for inadequate statin responders.
Author summary: Nonstatin therapies help patients who can't tolerate statins.