title: Combination therapy for dyslipidemia.
abstract: OBJECTIVE
  Residual cardiovascular risk remains in individuals treated with statins and combination therapies may reduce this risk further.
  
  
  RESULTS
  Most previous trials of combination therapies have shown a favorable effect on lipid profiles without clinical superiority over statin monotherapy. Trial design has been hampered by short duration and comparison with a low dose statin. The Study of Heart and Renal Protection trial has recently reported findings and shows a benefit of ezetimibe/simvastatin over simvastatin alone. AIM-HIGH (Atherothrombosis Intervention in Metabolic syndrome with Low HDL/High Triglycerides and Impact on Global Health Outcomes), a trial of statin/niacin, has been prematurely halted for futility. Finally, combining a statin with both niacin and ezetimibe shows significant enhancement of the therapeutic effect on lipid profiles.
  
  
  CONCLUSIONS
  Current evidence continues to support initiation of a potent statin with titration to achieve targets. Combinations may be useful in individuals unable to reach desired lipid levels on maximal tolerated doses of statins.
authors.affiliation: Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. msharma@Ottawahospital.on.ca
authors.forename: Mukul
authors.initials: M
authors.lastname: Sharma
mesh_terms: D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001384:Azetidines / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000188:drug therapy*; D000069438:Ezetimibe; D058607:Fibric Acids / Q000627:therapeutic use*; D006801:Humans; D009525:Niacin / Q000627:therapeutic use*
chemical_list: D000924:Anticholesteremic Agents; D001384:Azetidines; D058607:Fibric Acids; D009525:Niacin; D000069438:Ezetimibe