The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States.
Trends Cardiovasc Med. 2023 Apr;33(3):182-189. doi: 10.1016/j.tcm.2021.12.013. Epub 2021 Dec 30.
Fixed-dose combination (FDC) therapies (also known as polypills) remain underutilized in clinical practice despite over two decades of evidence from randomized controlled trials demonstrating increased adherence to multidrug therapy, improved cardiovascular disease (CVD) risk factor control, and lower incidence of cardiovascular events. Evidence demonstrates that FDC-based implementation strategies can substantially complement and augment current strategies for CVD risk prevention globally. The next decade is likely to extend the frontier of cardiovascular FDC therapies, particularly given expected advances in FDC manufacturing technology and accessibility. FDC-based anti-hypertensive therapies are emerging as integral components of a pragmatic blood pressure lowering strategy. Cardiovascular FDCs are rapidly approaching its coming of age, transforming from heavily hyped research tools to pragmatic clinical instruments. This review evaluates the current evidence for cardiovascular FDCs, barriers to current use, and potential next generation advances.
固定剂量复方制剂(FDC)疗法(也称为多药复方)尽管已有二十多年的随机对照试验证据表明其可提高多药物治疗的依从性、改善心血管疾病(CVD)风险因素控制并降低心血管事件发生率,但在临床实践中的应用仍不充分。有证据表明,基于 FDC 的实施策略可以极大地补充和增强目前全球 CVD 风险预防的策略。未来十年可能会扩展心血管 FDC 治疗的前沿领域,特别是考虑到 FDC 制造技术和可及性的预期进步。基于 FDC 的抗高血压治疗正在成为实用降压策略的重要组成部分。心血管 FDC 正在迅速走向成熟,从备受炒作的研究工具转变为实用的临床工具。本文评价了心血管 FDC 的现有证据、当前使用的障碍以及潜在的下一代进展。