Dyslipidemia: Greater Use of Combination Therapies Needed in Europe According to SANTORINI Study Results
Thierry MONOD, MD
CMVD World Operations Portfolio Project Director & Operational Director SW Europe and FOCIT
Before 2019, European data suggested that only one-fifth of high and very high-risk patients for cardiovascular (CV) events achieved the 2019 ESC/EAS recommended LDL cholesterol (LDL-C) goals. The SANTORINI observational study, which included 9,000 patients with dyslipidemia across 14 European countries—Italy (21%), Spain (11%), France (9%), Belgium (5%), and Portugal among them—sought to determine whether dyslipidemia treatment had improved or if gaps persisted between patient needs and physician prescriptions.
At the time of study enrollment, 80% of high and very high-risk patients failed to achieve the 2019 ESC/EAS guidelines for LDL-C goals (Lancet Reg Health Eur. 2023 Jun; 29: 100624). After one year of follow-up, the study confirmed that better LDL-C control was achieved with combination therapy, often involving the addition of ezetimibe to a statin. Use of combination therapy increased from 25.6% at the start of the study to 37.9% over one year, resulting in improved LDL-C control. However, only 31% of patients achieved their LDL cholesterol target levels, and across Europe, two-thirds of high and very high-risk patients remained above their risk-based goals.
According to the study authors, earlier and more widespread use of combination therapies is necessary to improve overall population-level control of LDL-C, particularly in high and very high-risk patients.
Ref: Ref: Use of combination therapy is associated with improved LDL-cholesterol management: 1-year follow-up results from the European observational SANTORINI study, Kausik K Ray & al, Eur J Prev Cardiol 2024 Jun 11:zwae199