2.19 Comparison of LDL-C Lowering Potential of Lipid-lowering Medicines
John Smithson
- identify the potency of the 4 major lipid lowering drug therapies available in Australia.
Of the 3 classes of lipid lowering drugs – statins, ezetimibe and PSCK9 inhibitors, the PSCK9 inhibitors are the most potent at reducing circulating LDL-C levels. They can reduce circulating LDL-C levels by between 30-60%.
Next most potent class of cholesterol lowering theapy are the statin class which can achieve a LDL-C lowering effect of between 25-55%. It is noteworthy that atorvastain and rosuvastatin, the two most potent statins have the greatest effect on lowering LDL-C.
Last is ezetimibe which can achieve a 15-25% reduction in circulating LDL-C levels.
If the patient has triglyceridemia, probably the most effective drug treatment are the fibrates. Fibrates can reduce triglycerides by 40-80% with a LDL reduction benefit of 5-15%.
Cost
It is worth understanding the cost of lipid-lowering therapies to the patient or the PBS. The following information provides a comparison of the cost to treat eleveated cholesterol for the first 6 months of treatment for hypercholesterolemia.
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