Selak Vanessa, Webster Ruth
University of Auckland, Auckland, New Zealand.
The George Institute for Global Health, Level 5, 1 King Street, Newtown, New South Wales, 2042, Australia.
Ther Adv Drug Saf. 2018 Feb;9(2):157-162. doi: 10.1177/2042098617747836. Epub 2017 Dec 20.
International guidelines recommend blood pressure-lowering therapy, statins and aspirin for people who have had a cardiovascular event but use of these medications is low, particularly for lower income countries. Clinical trials have demonstrated that combining these medications into a single pill or capsule (a 'polypill') improves adherence, systolic blood pressure and low density lipoprotein cholesterol compared with usual care in secondary prevention. Uptake of polypill-based care has been underwhelming, possibly due to safety concerns. Overall, results from the clinical trials of polypill use among people who have had a cardiovascular event show no immediate safety concerns. Increased use and adherence to medications will always be associated with side effects however use within a combination medication has not been shown to be any less safe than individual component medications. Research investigating the relative consequences of nonadherence to a polypill compared with individual components would be useful.
国际指南建议，对于发生过心血管事件的人群，应进行降压治疗、使用他汀类药物和阿司匹林，但这些药物的使用率较低，在低收入国家尤其如此。临床试验表明，与二级预防中的常规治疗相比，将这些药物组合成单一药丸或胶囊（“复方制剂”）可提高依从性、降低收缩压并降低低密度脂蛋白胆固醇。基于复方制剂的治疗方法的采用情况并不理想，这可能是由于安全担忧。总体而言，在发生过心血管事件的人群中使用复方制剂的临床试验结果显示，目前不存在直接的安全问题。然而，药物使用的增加和依从性的提高总会伴随着副作用，不过尚未证明复方制剂中的药物使用比单一成分药物的安全性更低。研究不依从复方制剂与不依从单一成分药物的相对后果将很有帮助。
