DE Luca Leonardo, Crispino Simone P, Andreoli Federico, DI Fusco Stefania A, Pannone Alfonso, Nusca Annunziata, Colivicchi Furio, Grigioni Francesco, Gabrielli Domenico
Division of Cardiology, Department of Cardio-Thoraco-Vascular Sciences, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy -
Department of Cardiovascular Sciences, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy.
Minerva Cardiol Angiol. 2024 Oct 8. doi: 10.23736/S2724-5683.24.06561-X.
Cardiovascular diseases (CVD) remain the leading cause of mortality globally and require innovative strategies for effective prevention and treatment. The polypill concept, which integrates multiple cardioprotective agents into a single dosage form, has emerged as a promising approach to improve adherence and simplify the management of cardiovascular risk factors. We review clinical trials and observational studies evaluating the impact of the polypill on reducing the incidence of major cardiovascular events (MACEs), its influence on medication adherence, and its potential to fill treatment gaps in diverse populations. Also of note are the pharmacoeconomic implications of the widespread use of the polypill, particularly in low- and middle-income countries where the burden of cardiovascular disease is increasing. Although the polypill demonstrates a favorable profile in improving therapeutic compliance and reducing cardiovascular risk factors, debates persist regarding its efficacy compared to individualized treatment regimens. This review summarizes the current evidence on the efficacy, safety, and cost-effectiveness of the polypill in CVD primary and secondary prevention. Furthermore, potential challenges in implementing the polypill strategy include tailoring the components to patient-specific risk profiles and the need for robust evidence from large-scale randomized controlled trials to substantiate its long-term benefits.
心血管疾病(CVD)仍然是全球主要的死亡原因,需要创新策略进行有效预防和治疗。将多种心脏保护药物整合到单一剂型中的复方制剂概念,已成为一种有前景的方法,可提高依从性并简化心血管危险因素的管理。我们回顾了评估复方制剂对降低主要心血管事件(MACE)发生率的影响、其对药物依从性的影响以及其填补不同人群治疗空白潜力的临床试验和观察性研究。复方制剂广泛使用的药物经济学意义也值得关注,特别是在心血管疾病负担日益增加的低收入和中等收入国家。尽管复方制剂在改善治疗依从性和降低心血管危险因素方面表现出良好的特征,但与个体化治疗方案相比,其疗效仍存在争议。本综述总结了复方制剂在心血管疾病一级和二级预防中疗效、安全性和成本效益的现有证据。此外,实施复方制剂策略的潜在挑战包括根据患者特定的风险概况调整成分,以及需要来自大规模随机对照试验的有力证据来证实其长期益处。