Zachary T. Bloomgarden, MD, MACE: We know that some individuals will receive a potent statin, or as much of a statin as they can tolerate (because some people develop really burdensome musculoskeletal complaints with statins). Yet, we’ll have evidence of atherosclerotic cardiovascular disease and have LDL (low-density lipoprotein) cholesterol levels [that] are above goal.
For such individuals, we now have a few choices [for treatment]. We can use the bile acid binding resins. We can use ezetimibe. We now can use the PCSK9 (proprotein convertase subtilisin kexin 9) inhibitors, which are tremendously potent agents for lowering LDL cholesterol and seem to be rather well tolerated.
I think this, essentially, represents a huge advance in the way that the dyslipidemia will be treated going forward. There’s the cost issue. There’s all these other things which are so important. So, we have to see how it all plays out, but the fact that we have so many choices is only going to help us to do a better job.