Background
Dyslipidaemia remains a major modifiable cardiovascular risk factor worldwide. Despite guideline recommendations, many patients do not reach LDL-C targets because of poor medication adherence and therapy discontinuation. Reducing pill burden through fixed-dose combination therapy is one approach to supporting treatment persistence.
Key points
- Fixed-dose therapy was associated with higher treatment adherence than free-combination therapy.
- Patients who persisted with treatment showed greater LDL-C reduction in the observed cohort.
- A lower pill burden may make long-term medicine routines easier to maintain.
What to look out for
- Poor treatment adherence
- Increased cardiovascular risk
- Multiple-pill burden
- Higher therapy discontinuation rate
- Suboptimal LDL-C reduction
At a glance
What this means in practice
OR 3.00 for adherence improvement with FDC versus free combination.
Treatment persistence was significantly longer with FDC.
Persistent patients achieved about 10% greater LDL-C reduction.
A simplified regimen may support consistent medicine taking.
Improved adherence was associated with a lower cardiovascular-risk trend.
Evidence summary
Patients persistent to therapy showed approximately 10% greater LDL-C reduction compared with non-persistent patients. Adherent patients demonstrated nearly 9.6% better LDL-C reduction, highlighting the clinical value of fixed-dose combination therapy in real-world practice.
References
- Sanmaliev M, et al. Treatment adherence and persistence with rosuvastatin/ezetimibe fixed-dose combination versus free combination: a retrospective cohort study. Front Cardiovasc Med. 2025;12:1461416.
- Mach F, et al. ESC/EAS Guidelines for the management of dyslipidaemias. Eur Heart J. 2023;44(S5):e28-e60.
- Kalbe Medical Review. Fixed-dose combination for optimal adherence. KalbeMed J. 2026;12(1):15-22.
- Cannon CP, et al. Efficacy and safety of combination lipid-lowering therapy. Nat Rev Cardiol. 2024;21(3):111-125.