Clinical tools · Lipids
Lipid-Lowering Switch Calculator
Enter the current regimen and a measured LDL-C. The tool reconstructs the untreated baseline, then projects what a different regimen would give.
Statin, ezetimibe, bempedoic acid and PCSK9-directed therapy (evolocumab, alirocumab or inclisiran) are modelled as combining multiplicatively, since each reports its reduction on top of background therapy. Educational aid for clinicians — not a substitute for a measured pre-treatment profile or clinical judgement.
Current regimen · measured
Use direct or Martin-Hopkins LDL if low or triglycerides high; Friedewald under-reads at low LDL.
Reconstructed untreated baseline LDL-C
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Switch to · projected
Projected LDL-C
—mmol/L
Range — to —
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ApoB projected —
Current reduction
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Proposed reduction
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LDL-C axis · baseline to current to projected
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Untreated baseline (reconstructed)
Current, measured
Projected on new regimen
Assumptions and efficacy table
| Statin | 10 mg | 20 mg | 40 mg | 80 mg |
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Statins: mean LDL-C reduction anchored on STELLAR (Jones 2003); micro-doses (†) extrapolated below RCT range. Ezetimibe 10 mg add-on 22%, 5 mg ~19%. Bempedoic acid 18% on a statin, 21% without (CLEAR Harmony/Wisdom/Serenity); with ezetimibe the multiplicative result matches the ~38% fixed-combo figure. Evolocumab ~60% on or off statin (FOURIER, OSLER), with a tighter response band than statins. Alirocumab is modelled with evolocumab as a single mAb class effect. Inclisiran ~50% (ORION), a twice-yearly siRNA. All three act on the PCSK9 pathway and are therefore mutually exclusive in this tool. ApoB modelled at 0.85 of LDL-C reduction; note bempedoic acid lowers apoB proportionally less (~0.66), so apoB reads slightly optimistic when it is included. Rosuvastatin is Special Authority; bempedoic acid and PCSK9i are not Pharmac-funded (self-pay) as of 2026.