The American Association of Clinical Endocrinology (AACE) has introduced a new guideline for managing dyslipidemia, which refers to abnormal cholesterol levels. This guideline provides evidence-based recommendations for newer drug therapies and emphasizes patient-centered outcomes, particularly the reduction of cardiovascular disease (CVD) risk. It is intended for adults aged 18 and older who have dyslipidemia or high triglycerides and are already receiving standard treatment but may need additional medications.
One of the key updates is a change in cholesterol treatment targets. The new guideline sets an LDL-C (bad cholesterol) goal of less than 70 mg/dL for individuals at high risk of CVD, based on recent evidence. This replaces the earlier target of 55 mg/dL, as lower levels have shown only minimal additional benefits in preventing heart attacks and mortality.
The recommendations were crafted using the GRADE methodology, which assesses the strength of evidence at the outcome level. This method has influenced the perception of newer medications. For instance, PCSK9 inhibitors such as alirocumab and evolocumab are recommended as additional options for patients at higher CVD risk, but not for those without CVD. Likewise, eicosapentaenoic acid is advised for high-risk patients with elevated triglycerides, while niacin and combined omega-3 therapies are not recommended due to their limited benefits.
The guideline also points out the restricted role of nontraditional risk assessments, including coronary artery calcium and apolipoprotein B. Although these tests may be useful in specific situations, they provide only a slight enhancement in evaluating CVD risk.
Created by a multidisciplinary team, the guideline stresses the importance of shared decision-making between healthcare providers and patients, taking into account factors such as costs, preferences, and equity. It features tools like flow diagrams and medication tables to aid in implementation, along with a summary designed for patients.
This update reflects an evolving understanding of CVD risk management and promotes personalized treatment plans to enhance patient outcomes.
Source: www.medscape.com/viewarticle/aace-publishes-guideline-drug-management-dyslipidemia-2025a10003sy
