What do you think, what drug should be added for management of a hypercholestrolemic patient if statins have been unable to control it?

General
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Vote between ezetimibe and evolozumab

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We should start with ezetimibe because (less expetand more tolerable) then should go on to next i.e evolozubam

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Ezetimibe :-First-line add-on to statins

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  1. Maximize Statin Therapy
    β€’ Ensure the patient is on the maximum tolerated dose of a high-intensity statin (e.g., atorvastatin 40–80 mg or rosuvastatin 20–40 mg).

βΈ»

  1. Add Ezetimibe
    β€’ First-line add-on therapy to statins.
    β€’ Mechanism: Inhibits intestinal cholesterol absorption.
    β€’ Can reduce LDL-C by an additional ~15–20%.

βΈ»

  1. Add a PCSK9 Inhibitor
    β€’ For high-risk patients (e.g., established ASCVD or familial hypercholesterolemia) who are still above LDL-C targets despite statin + ezetimibe.
    β€’ Options: Alirocumab, Evolocumab.
    β€’ LDL-C reduction: ~60% additional drop.
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