THINK BEYOND LDL-C TARGETS WITH PROVEN CV RISK REDUCTION

Concomitant use of NUSTENDI®/NILEMDO® with simvastatin >40 mg daily is contraindicated; please refer to the relevant SmPC for more information.^1,2

*For study results with respect to effects on LDL-C, CV events and populations studied see section 5.1 of the relevant SmPC.^1,2

CV risk reduction estimation for ezetimibe in primary prevention patients has not been established. Evidence for the use of NUSTENDI® in patients at high risk of ASCVD is only available for the lipid-lowering effect (see section 5.1 of the NUSTENDI® SmPC).²

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Latest expert opinions

Managing CVD risk in patients with diabetes and elevated LDL-C

Adult patients with diabetes are 3-5 times more likely to have CV hospital admission and approximately 3-5 times more likely to die from CVD compared to those without diabetes.⁶

Cholesterol management is one vital component of a holistic approach to CV risk reduction in diabetes care. When treating patients with diabetes, the greatest reductions in CV risk and mortality are seen with combined long-term risk factor management of blood pressure, HbA1c and lipids.^7,8

In a retrospective outpatient study that looked at 281,381 patients with diabetes in Italy, ≥60% of patients with diabetes with LLT did not reach guideline-recommended LDL-C goals (ESC/EAS 2016-2019), therefore remained at increased risk of CVD.^{9,10,*, †}

Join leading experts, Dr. Patrick Holmes and Beverley Bostock, as they delve into key considerations for managing hypercholesterolaemia and mixed dyslipidaemia in patients with diabetes, with a focus on reducing their heightened CV risk through effective LLTs.

In this video, they review current practices for managing patients with diabetes, address common patient concerns and barriers to initiating LLT, and discuss the available treatment options, highlighting the importance of selecting the right therapy for each patient.

Explore the efficacy data for NUSTENDI® and NILEMDO® or the ESC/EAS 2025 guidelines.

^*Patients receiving combination therapy of statin + ezetimibe (N=4,516).^9
†ESC/EAS 2019 guidelines definitions: ^†Very high risk: defined as people with any of the following: documented ASCVD, either clinical or unequivocal on imaging; documented ASCVD includes previous ACS (MI or unstable angina), stable angina, coronary revascularisation (PCI, CABG, and other arterial revascularisation procedures), stroke and TIA, and PAD; unequivocally documented ASCVD on imaging includes those findings that are known to be predictive of clinical events, such as significant plaque on coronary angiography or CT scan (multivessel coronary disease with two major epicardial arteries having >50% stenosis), or on carotid ultrasound; DM with target organ damage,^‡ or at least three major risk factors, or early onset of T1DM of long duration (>20 years); severe CKD (eGFR <30 mL/min/1.73 m²); a calculated SCORE ≥10% for 10-year risk of fatal CVD; FH with ASCVD or with another major risk factor. High risk: defined as people with: markedly elevated single risk factors, in particular total cholesterol >8 mmol/L (>310 mg/dL), LDL-C >4.9 mmol/L (>190 mg/dL), or BP ≥180/110 mmHg; patients with FH without other major risk factors; patients with DM without target organ damage,^‡ with DM duration ≥10 years or another additional risk factor; moderate CKD (eGFR 30–59 mL/min/1.73 m²); a calculated SCORE ≥5% and <10% for 10-year risk of fatal CVD. Moderate risk: defined as young patients (T1DM <35 years; T2DM <50 years) with DM duration <10 years, without other risk-factors; a calculated SCORE ≥1% and <5% for 10-year risk of fatal CVD.^10
‡Target organ damage is defined as microalbuminuria, retinopathy, or neuropathy.¹⁰