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A review of time courses and predictors of lipid changes with fenofibric acid-statin combination.

Filippatos TD - Cardiovasc Drugs Ther (2012)

Bottom Line: Fibrates activate peroxisome proliferator activated receptor α and exert beneficial effects on triglycerides, high-density lipoprotein cholesterol, and low density lipoprotein subspecies.The combination of FA with simvastatin, atorvastatin and rosuvastatin resulted in greater improvement of the overall lipid profile compared with the corresponding statin dose.The long-term efficacy of FA combined with low- or moderate- dose statin has been demonstrated in a wide range of patients, including patients with type 2 diabetes mellitus, metabolic syndrome, or elderly subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece. filtheo@gmail.com

ABSTRACT
Fibrates activate peroxisome proliferator activated receptor α and exert beneficial effects on triglycerides, high-density lipoprotein cholesterol, and low density lipoprotein subspecies. Fenofibric acid (FA) has been studied in a large number of patients with mixed dyslipidemia, combined with a low- or moderate-dose statin. The combination of FA with simvastatin, atorvastatin and rosuvastatin resulted in greater improvement of the overall lipid profile compared with the corresponding statin dose. The long-term efficacy of FA combined with low- or moderate- dose statin has been demonstrated in a wide range of patients, including patients with type 2 diabetes mellitus, metabolic syndrome, or elderly subjects. The FA and statin combination seems to be a reasonable option to further reduce cardiovascular risk in high-risk populations, although trials examining cardiovascular disease events are missing.

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Related in: MedlinePlus

Lipid alterations (%) with the combination of fenofibric acid (FA) 135 mg/day with simvastatin compared with simvastatin alone [22]. * p < 0.05 vs. corresponding statin dose. &p < 0.05 vs. FA monotherapy. Bars represent mean ± SEM. The numbers with white color represent the baseline values, whereas the numbers with black color represent the percent changes. HDL-C = high-density lipoprotein cholesterol, TG = triglycerides, LDL-C = low-density lipoprotein cholesterol
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Fig2: Lipid alterations (%) with the combination of fenofibric acid (FA) 135 mg/day with simvastatin compared with simvastatin alone [22]. * p < 0.05 vs. corresponding statin dose. &p < 0.05 vs. FA monotherapy. Bars represent mean ± SEM. The numbers with white color represent the baseline values, whereas the numbers with black color represent the percent changes. HDL-C = high-density lipoprotein cholesterol, TG = triglycerides, LDL-C = low-density lipoprotein cholesterol

Mentions: The FA/simvastatin study randomized 657 patients of whom 621 were available for analysis [22]. FA + simvastatin 20 mg/day produced a greater increase in HDL-C (17.8 % vs. 7.2 %, p < 0.001) and a greater decrease in TG levels (−37.4 % vs. −14.2 %, p < 0.001) and very low-density lipoprotein cholesterol (VLDL-C) levels (−38.9 % vs. −19.2 %, p < 0.01) compared with simvastatin 20 mg/day (Fig. 2). In addition, FA + simvastatin 20 mg/day resulted in a greater LDL-C decrease compared with FA monotherapy (−24.0 % vs. −4.0 %, p < 0.001). Similarly, FA + simvastatin 40 mg/day produced a greater increase in HDL-C (18.9 % vs. 8.5 %, p < 0.001) and a greater decrease in TG levels (−42.7 % vs. −22.4 %, p < 0.001) and VLDL-C (−51.1 % vs. −35.7 %, p < 0.01) compared with simvastatin 40 mg/day, as well as a greater LDL-C decrease compared with FA monotherapy (−25.3 % vs. −4.0 %, p < 0.001) (Fig. 2). FA + simvastatin 20 mg/day resulted in significantly greater reductions in non-HDL-C, VLDL-C, total cholesterol (TC) and apoB compared with simvastatin 20 mg/day monotherapy (p ≤ 0.012). FA + simvastatin 40 mg/day resulted in similar reductions in non-HDL-C, apoB, TC, and hsCRP compared with simvastatin 40 mg/day [22].Fig. 2


A review of time courses and predictors of lipid changes with fenofibric acid-statin combination.

Filippatos TD - Cardiovasc Drugs Ther (2012)

Lipid alterations (%) with the combination of fenofibric acid (FA) 135 mg/day with simvastatin compared with simvastatin alone [22]. * p < 0.05 vs. corresponding statin dose. &p < 0.05 vs. FA monotherapy. Bars represent mean ± SEM. The numbers with white color represent the baseline values, whereas the numbers with black color represent the percent changes. HDL-C = high-density lipoprotein cholesterol, TG = triglycerides, LDL-C = low-density lipoprotein cholesterol
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Related In: Results  -  Collection

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Fig2: Lipid alterations (%) with the combination of fenofibric acid (FA) 135 mg/day with simvastatin compared with simvastatin alone [22]. * p < 0.05 vs. corresponding statin dose. &p < 0.05 vs. FA monotherapy. Bars represent mean ± SEM. The numbers with white color represent the baseline values, whereas the numbers with black color represent the percent changes. HDL-C = high-density lipoprotein cholesterol, TG = triglycerides, LDL-C = low-density lipoprotein cholesterol
Mentions: The FA/simvastatin study randomized 657 patients of whom 621 were available for analysis [22]. FA + simvastatin 20 mg/day produced a greater increase in HDL-C (17.8 % vs. 7.2 %, p < 0.001) and a greater decrease in TG levels (−37.4 % vs. −14.2 %, p < 0.001) and very low-density lipoprotein cholesterol (VLDL-C) levels (−38.9 % vs. −19.2 %, p < 0.01) compared with simvastatin 20 mg/day (Fig. 2). In addition, FA + simvastatin 20 mg/day resulted in a greater LDL-C decrease compared with FA monotherapy (−24.0 % vs. −4.0 %, p < 0.001). Similarly, FA + simvastatin 40 mg/day produced a greater increase in HDL-C (18.9 % vs. 8.5 %, p < 0.001) and a greater decrease in TG levels (−42.7 % vs. −22.4 %, p < 0.001) and VLDL-C (−51.1 % vs. −35.7 %, p < 0.01) compared with simvastatin 40 mg/day, as well as a greater LDL-C decrease compared with FA monotherapy (−25.3 % vs. −4.0 %, p < 0.001) (Fig. 2). FA + simvastatin 20 mg/day resulted in significantly greater reductions in non-HDL-C, VLDL-C, total cholesterol (TC) and apoB compared with simvastatin 20 mg/day monotherapy (p ≤ 0.012). FA + simvastatin 40 mg/day resulted in similar reductions in non-HDL-C, apoB, TC, and hsCRP compared with simvastatin 40 mg/day [22].Fig. 2

Bottom Line: Fibrates activate peroxisome proliferator activated receptor α and exert beneficial effects on triglycerides, high-density lipoprotein cholesterol, and low density lipoprotein subspecies.The combination of FA with simvastatin, atorvastatin and rosuvastatin resulted in greater improvement of the overall lipid profile compared with the corresponding statin dose.The long-term efficacy of FA combined with low- or moderate- dose statin has been demonstrated in a wide range of patients, including patients with type 2 diabetes mellitus, metabolic syndrome, or elderly subjects.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, School of Medicine, University of Ioannina, 45110 Ioannina, Greece. filtheo@gmail.com

ABSTRACT
Fibrates activate peroxisome proliferator activated receptor α and exert beneficial effects on triglycerides, high-density lipoprotein cholesterol, and low density lipoprotein subspecies. Fenofibric acid (FA) has been studied in a large number of patients with mixed dyslipidemia, combined with a low- or moderate-dose statin. The combination of FA with simvastatin, atorvastatin and rosuvastatin resulted in greater improvement of the overall lipid profile compared with the corresponding statin dose. The long-term efficacy of FA combined with low- or moderate- dose statin has been demonstrated in a wide range of patients, including patients with type 2 diabetes mellitus, metabolic syndrome, or elderly subjects. The FA and statin combination seems to be a reasonable option to further reduce cardiovascular risk in high-risk populations, although trials examining cardiovascular disease events are missing.

Show MeSH
Related in: MedlinePlus