Oral treatment enough to lower cholesterol in most patients

Nearly nine in 10 patients with atherosclerotic cardiovascular disease (ASCVD) could improve their cholesterol levels with oral-only treatment, according to a new study.

In a simulation cohort of 1 million people with ASCVD, a JAMA Cardiology investigation found 67.3 percent could achieve a low-density lipoprotein cholesterol (LDL-C) level below 70 mg/dL by taking only statin. Adding ezetimibe would push 86 percent of patients below that threshold, while the remaining 14 percent would require add-on injections from proprotein convertase subtilisin/kexin type 9 inhibitors.

With these progressively intensified lipid-lowering therapies, more than 99 percent of the population with ASCVD could reach LDL-C levels below 70 mg/dL, according to the study.

The researchers drew from a large administrative database of U.S. medical and pharmacy claims from 2012-13 to identify 105,269 individuals who met criteria for inclusion. Using the bootstrapping method, individuals were randomly sampled and replaced to create a simulation cohort of one million.