Safety of combined hypolypidemic therapy in clinical practice

Relevance. Atherogenic dyslipidemia is a key factor in the development of atherosclerotic cardiovascular diseases, which for many years remain the leading cause of mortality worldwide. Cardiovascular mortality can be reduced and prevented by correcting modifiable risk factors, in particular by eliminating hypercholesterolemia. Purpose of the study. To evaluate treatment adherence, side effects and negative events of triple cholesterol-lowering therapy. Materials and methods. Alirocumab therapy at a dose of 150 mg/ml once every 2 weeks for 3 months was performed in 103 patients living in the Moscow region with atherogenic dyslipidemia. All patients had a high or very high cardiovascular risk group. Before starting alirocumab therapy, patients received monotherapy with atorvastatin at a dose of 40–80 mg or combination therapy with atorvastatin in combination with ezetimibe or fenofibrate. Results. A decrease in total cholesterol and LDL cholesterol with additional alirocumab therapy was observed in all 103 patients. No exacerbations of coronary heart disease, new cases of acute cerebrovascular accident and transient ischemic attacks were registered. No negative dynamics in the glycemic profile of patients with type 2 diabetes mellitus was revealed. The treatment was not accompanied by obvious adverse reactions and complications. Conclusion. A three-month course of triple lipid-lowering therapy was characterized by high patient adherence to treatment, good tolerance and no complications. Combined lipid-lowering therapy contributed to the clinical stabilization of coronary heart disease, did not have a negative impact on the course of diabetes mellitus, and was not accompanied by adverse reactions.