(RxWiki News) A more intensive dose of cholesterol-lowering statins appears to help higher risk patients better manage cholesterol, a new study suggests.
The review study also determined that adding another cholesterol-lowering drug to a statin is far less valuable for moderate to high risk patients.
The researchers found that in most cases increasing the dosage of a statin could offer the best protection from more serious heart problems.
"Consider lifestyle changes before any medication."
Study author Matt Ito, PharmD, a professor of pharmacy practice at Oregon State University and president-elect of the National Lipid Association, noted that statins are proven to reduce heart attacks and strokes in about 30 percent of patients who need the medication.
He said the review study found that in most cases adding other drugs or therapies to statins didn't help, though increasing statin dosage appeared to offer a benefit. Researchers looked only at increasing the dosage of statins within an approved range.
They also determined there was no significant increase in side effects when the dosage was increased.
Investigators emphasized it's still best to wait and try statins after first trying diet changes, weight loss and added exercise.
During the review study researchers evaluated randomized controlled trials performed between 2004 and 2012 that examined use of cholesterol-lowering medication among patients with high cholesterol, low "good" HDL cholesterol or elevated triglycerides.
Some meta-analyses also were included.
Dr. Ito said it was even an advantage over taking a combination of drugs, which in some cases result in more risk than benefit. Atorvastatin (Lipitor) and rosuvastatin (Crestor) were among statins researchers found suitable for taking alone at an increased dosage.
“The reaction to statin regimens varies with the individual, so some of these other drugs may also be able to accomplish the goals we’re seeking,” Dr. Ito said. “These recommendations are based on results with an average patient, but physicians may find some of their patients can do adequately well with other statins, or that they don’t need intensive monotherapy.”
Dr. Ito has received honoraria for speaking from drugmakers GlaxoSmithKline, Kowa/Lilly, and Abbott. He also serves on advisory boards for Kowa/Lilly and Daiichi Sankyo.
The study was recently published in journal Annals of Pharmacotherapy.