HealthDay News — Expert consensus guidance has been issued regarding the use of non-statin therapies to lower cholesterol in high-risk patients. The consensus document was published online April 1 in the Journal of the American College of Cardiology to coincide with presentation at the annual meeting of the American College of Cardiology, held from April 2 to 4 in Chicago.

Donald M. Lloyd-Jones, MD, from Northwestern University in Chicago, and colleagues reviewed the evidence and provided guidance for clinicians and patients in one of the four evidence-based statin benefit patient groups identified in the 2013 American College of Cardiology/American Heart Association cholesterol guideline. The algorithms are based on the assumption that the patient is taking or has attempted to take a statin and that the clinician and patient are trying to determine whether additional therapy is needed.

The authors recommend consideration of multiple factors, including adherence and lifestyle; statin intolerance; control of other risk factors; clinician-patient discussion regarding patient preferences and potential benefits and harms of non-statin therapy; percentage low-density lipoprotein cholesterol reduction; and monitoring response. The authors support consideration of adding ezetimibe 10mg daily for many higher-risk patient groups. No clear indications were found for the use of niacin preparations as additional non-statin therapy.

“Before initiation of combination therapy, it is imperative for clinicians and patients to engage in a discussion that includes the potential for net,” Lloyd-Jones said in a statement.

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Several authors disclosed financial ties to the pharmaceutical industry.

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