Article

The effects of fenofibric acid alone and with statins on the prevalence of metabolic syndrome and its diagnostic components in patients with mixed dyslipidemia.

Louisville Metabolic and Atherosclerosis Research Center, Louisville, Kentucky, USA.
Diabetes care (Impact Factor: 7.74). 09/2010; 33(9):2113-6. DOI: 10.2337/dc10-0357
Source: PubMed

ABSTRACT To compare fenofibric acid (FA) + statin to respective monotherapies on the prevalence of metabolic syndrome and its diagnostic components in patients with mixed dyslipidemia.
Post hoc analysis of over 2,000 metabolic syndrome patients administered either FA + low- or moderate-dose statin; FA alone; or low-, moderate-, or high-dose statin alone.
FA + low- or moderate-dose statin combination therapy reduced the presence of metabolic syndrome (35.7 or 35.9%, respectively) more than low-, moderate-, or high-dose statin monotherapy (15.5, 16.6, or 13.8%, respectively), mostly due to improvements in triglycerides and HDL cholesterol levels. Mean glucose levels slightly decreased with FA monotherapy, slightly increased with statin monotherapy, and were essentially unchanged with FA + statin. FA with or without statin also reduced non-HDL cholesterol, apolipoprotein B, total cholesterol, VLDL cholesterol, and high-sensitivity C-reactive protein.
FA + statin in patients with mixed dyslipidemia reduces the prevalence of metabolic syndrome.

0 Bookmarks
 · 
97 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients do not just wake up one morning with cardiac disease. Instead there is an extended preclinical phase during which lifestyle choices determine outcome. Recent advances in our understanding of oxidative stress, endocrine signaling, immune/inflammatory balance, and energy production illuminate opportunities for efficacious intervention. A thorough exploration of these pathophysiologies will allow physicians the opportunity to offer their patients a journey away from illness and disease to optimal wellness.
    Global advances in health and medicine : improving healthcare outcomes worldwide. 05/2012; 1(2):38-45.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Background: Patients with mixed dyslipidemia can benefit from the combination of fenofibric acid (FA) with statins, but concerns about adverse events make physicians reluctant to prescribe the combination therapy. Objective: In the present study, we performed a meta-analysis of randomized controlled trials (RCTs) to assess the efficacy and adverse events in patients taking statins and FA. Methods: Medline, Embase and the Cochrane Library were searched to identify studies that reported adverse events. Finally, 5 trials covering 2704 patients were selected in this study. Results: There were significant decreases in TG and increases in HDL-C in patients receiving combination therapy compared with statin monotherapy. The incidence of hepatic toxicity (OR, 3.57; 95%CI, 1.17-10.83; P<0.05) and increased creatinine (OR, 3.22; 95%CI, 1.28-8.11; P<0.05) was significantly higher in FA+low-dose statin group than in the corresponding statin monotherapy. The incidence of CK elevations and muscle-associated AEs was not statistically different between the two groups. The adverse events in FA+moderate-dose statin were almost identical to those in FA+low-dose statin group. Conclusions: In conclusion, combination therapy could improve the blood lipid profile. Addition of FA to statins therapy is more frequently associated with hepatic and renal toxicity than muscle-associated AEs. The combination of FA with statins should be recommended to patients under monitoring of liver enzyme and renal function. However, we still need large-scale and long follow-up period RCTs to definitively confirm the adverse events of FA-statin therapy.
    Current Medical Research and Opinion 01/2013; · 2.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia, insulin resistance, and/or progressive loss of β-cell function. T2DM patients are at increased risk of micro- and macrovascular disease, and are often considered as representing an atherosclerotic coronary heart disease (CHD) risk equivalent. Interventions directed at glucose and lipid level control in T2DM patients may reduce micro- and macrovascular disease. The optimal T2DM agent is one that lowers glucose levels with limited risk for hypoglycemia, and with no clinical trial evidence of worsening CHD risk. Lipid-altering drugs should preferably reduce low-density lipoprotein cholesterol and apolipoprotein B (apo B) and have evidence that the mechanism of action reduces CHD risk. Statins reduce low-density lipoprotein cholesterol and apo B and have evidence of improving CHD outcomes, and are thus first-line therapy for the treatment of hypercholesterolemia. In patients who do not achieve optimal lipid levels with statin therapy, or who are intolerant to statin therapy, add-on therapy or alternative therapies may be indicated. Additional available agents to treat hypercholesterolemic patients with T2DM include bile acid sequestrants, fibrates, niacin, and ezetimibe. This review discusses the use of these alternative agents to treat hypercholesterolemia in patients with T2DM, either as monotherapy or in combination with statin therapy.
    International Journal of General Medicine 01/2014; 7:355-64.

Full-text (3 Sources)

View
25 Downloads
Available from
Jun 5, 2014