Thursday, September 17, 2015

Update on Tubby Theory - Add Zetia to list of proven drugs and lower LDLc is better








The Tubby Theory advises goal LDLp <750 nbsp="" p="">
IMPROVE-IT showed that lower LDLc is better.


Dr. Dayspring disagrees with using Niacin before Zetia as a second drug. I quoted an article on March 26,2014 by Dr. Dayspring where he defended Niacin in 2 of the outcome trials before, but now he reverses himself. 
 Here is an exchange I had on twitter with him. 

 Sep 16
Need trial low dose combo vs. high dose statin in high risk naive drug group before we can be certain which is best


 I am with  on this one. Almost no use for niacin in todays Rx - too toxic & failure in all 3 outcome trials


 19 hours ago
Did I misquote?


How would you know what that Rx combination is achieving without enrolling thousands in a multiple arm blinded trial?

  1. I am suggesting a head to head trial is needed in naive drug patients. Low dose statin/matrix niacin 1k mg vs High dose statin. Result?? 
  2.  19 hours agoTopeka, KS
    I one arm does not reach LDLp goal then add zetia to that arm.
  3.  19 hours agoTopeka, KS
    Goal is to avoid side effects while reaching LDLp goal.
  1.  23 hours ago
    I love Zetia as 3rd drug. Economics for society calls for cheapest, safest treatment.


    Anyone considering adding niacin to statin rather than ezetimibe needs to read Simply look at the graphic


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