New guidance should help doctors better manage hard-to-treat hypercholesterolaemia in patients at very high-risk of a cardiovascular event, say its authors.

In their BMJ paper, published earlier this month, the international panel of clinicians recommends when to use ezetimibe and/or proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors in patients with high LDL cholesterol (LDL-C) who are on a the maximum dose of statins or are intolerant to them.

They say the new advice is needed because it is “almost impossible” to achieve LDL-C targets in patients at very high-risk of a CV event with statins alone, as set out in other guidelines.

This meant doctors were increasingly using ezetimibe and/or PCSK9 inhibitors to achieve LDL-C treatment goals, rather than for the “important” reduction of absolute cardiovascular risk.