A Meta-Analysis Assessing Additional LDL-C Reduction from Addition of a Bile Acid Sequestrant to Statin Therapy

Statins are the first line therapy for reducing low-density lipoprotein cholesterol (LDL-c) in those shown to benefit.1 However, there are secondary prevention patients who are either intolerant to maximal statin therapy or do not get adequate cholesterol lowering from a high-intensity statins. In such cases, national guidelines recommend the addition of nonstatin medications such as ezetimibe or PCSK9 inhibitors to statin therapy for additional LDL-C lowering.1 The landmark Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) trial showed the benefit of bile acid sequestrants both for LDL-c lowering and reducing morbidity and mortality from cardiovascular disease.