Prevention: Edited by Andrew PipeCombination therapy for dyslipidemiaSharma, MukulAuthor Information Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada Correspondence to Mukul Sharma MD, MSc, FRCPC, Department of Medicine, University of Ottawa, Ottawa Hospital Research Institute, 725 Parkdale Avenue, Ottawa, Ontario K1Y 4E9, Canada Tel: +1 613 761 4395; e-mail: [email protected] Current Opinion in Cardiology: September 2011 - Volume 26 - Issue 5 - p 420-423 doi: 10.1097/HCO.0b013e3283499ef1 Buy Metrics Abstract Purpose of review Residual cardiovascular risk remains in individuals treated with statins and combination therapies may reduce this risk further. Recent findings 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. Summary 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. © 2011 Lippincott Williams & Wilkins, Inc.