Fixed dose compound therapy (hereinafter referred to as “multi-effect pill”) is to make antiplatelet, antihypertensive and cholesterol-lowering drugs into a single pill according to a certain dose. It is mainly used for prevention of cardiovascular diseases (CVD) and is suitable for areas where medical resources are scarce because of its relatively low cost and good compliance.
First, multi-effect pills reduce systolic blood pressure and total cholesterol
The results showed that the systolic blood pressure in the multi-effect pill intervention group decreased by 13.4 mmHg and that in the control group by 6.3 mmHg. The total cholesterol level in the multi-effect pill intervention group decreased by 33.3 mg/dl and that in the control group by 4.3 mg/dl.
Second, multi-effect pills are related to the increase in the incidence of adverse events.
But research also shows that, Multiple-effect pills were associated with a higher incidence of adverse events. The incidence of adverse events in the multiple-effect pill intervention group was higher than that in the control group (29.7% vs 24.2%). The three most reported adverse events in the two treatment groups were elevated liver function indexes (7.8% vs 7.6% in the multi-effect pill group), cough (6.4% vs 3.5% in the control group) and myalgia (4.0% vs 3.6% in the multi-effect pill group).
III. Discussion
Compared with conventional therapy, active control drug or placebo therapy, multi-effect pill therapy is associated with lower blood pressure and cholesterol, probably due to higher compliance in multi-effect pill therapy group. In CVD prevention, multi-effect pill may be used as an adjuvant therapy rather than a substitute for existing conventional therapy.
Existing clinical guidelines have adopted the strategy of lowering blood pressure combined with therapy to control hypertension, but there is no guideline to recommend multi-effect pills for CVD prevention. Multi-effect pills have not yet been included in WHO’s Essential Drug Demonstration Catalogue.