Improving Statin Adherence and Optimizing Combination Therapy

In Improving Statin Adherence and Optimizing Combination Therapy, our panel delves into the following critical questions:

Besides statin intolerance, adherence to the class as a whole has been suboptimal. How common is lack of adherence and what are the main reasons for it?

How much of this lack of adherence do you attribute to pill burden?

Could lack of adherence also be lower due to lack of benefit felt by patients?

How do you determine when to add on a therapy to a statin or when to switch therapies?

Led by the moderator, the panelists discuss suboptimal adherence to statins, which is common, with many patients discontinuing therapy due to side effects, complex regimens, or a perceived lack of immediate benefit. Pill burden can contribute significantly, particularly in patients taking multiple medications for comorbid conditions. Additionally, some patients may be less motivated to maintain therapy because they do not feel tangible benefits from statin use, despite long-term cardiovascular protection. Decisions to add on or switch therapies are guided by LDL-C response, residual cardiovascular risk, tolerance, and guideline-directed targets, often incorporating a stepwise approach to optimize outcomes.

Throughout the conversation, the experts provide a comprehensive reflection on the field and the factors that may shape how clinicians approach care moving forward.

Our next episode, Guideline Updates and Optimizing Adherence in Post-ACS Lipid Management, further explores the 2025 ACC/AHA recommendations for managing patients after a recent acute coronary syndrome and considers how 2026 updates may influence clinical practice. It also examines adherence patterns with PCSK9 inhibitors compared to inclisiran, highlighting study methods and results that may inform strategies to improve long-term LDL-C control.