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Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia.
Kardiol Pol 2004; 60(6):567-77KP

Abstract

BACKGROUND

Statins are the preferred drugs for the treatment of hypercholesterolemia, and fibrates for hypertriglyceridemia. In patients with mixed hyperlipidemia, monotherapy with one of these agents may not be effective and combined treatment may be preferable.

AIM

To compare retrospectively the efficacy and safety of combined statin-fibrate treatment in patients with mixed hyperlipidemia in whom previous monotherapy with one of these agents occurred ineffective.

METHODS AND RESULTS

The initial study group consisted of 327 patients who received micronised fenofibrate and 93 patients who received simvastatin for 12 months. Both agents caused significant changes in lipid profile. Following fibrate therapy, total cholesterol (TC), LDL-cholesterol (LDL-C) and triglyceride (TG) levels decreased by 27.9%, 28.2% and 58%, respectively, and following simvastatin therapy by 33.6%, 42.8% and 37.5%, respectively. The HDL-cholesterol (HDL-C) level increased after fenofibrate by 14.8% and remained unchanged following simvastatin therapy. The TC/HDL-C ratio decreased following fenofibrate by 35.6%, and following simvastatin by 35.3%. In some patients the required reduction in lipid parameters was not achieved fenofibrate or simvastatin. Subsequently, 93 patients underwent combined therapy by adding a second agent (simvastatin in a dose of 20 mg/day or fenofibrate in a dose of 200 mg per day) which was continued for another 12 months. The addition of simvastatin to fenofibrate decreased TC, LDL-C and TG levels by 35.5%, 42.1% and 59.6%, respectively in comparison to before treatment volumes. HDL-C level was increased by 11.1%, and TC/HDL-C ratio decreased by 45.3%. The addition of fenofibrate to simvastatin decreased TC, LDL-C and TG levels by 39.3%, 48.9% and 51,6%, respectively. HDL-C level was increased by 13.4%, and TC/HDL-C ratio decreased by 49.3%. No clinical side effects nor an increase in the transaminase levels, requiring termination of the treatment, were observed.

CONCLUSIONS

Combined therapy with 20 mg of simvastatin and 200 mg of micronised fenofibrate is highly effective and safe in patients with mixed hyperlipidemia.

Authors+Show Affiliations

National Food and Nutrition Institute, Warsaw, Poland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng pol

PubMed ID

15334157

Citation

Kłosiewicz-Latoszek, Longina, et al. "Comparison of Combined Statin-fibrate Treatment to Monotherapy in Patients With Mixed Hyperlipidemia." Kardiologia Polska, vol. 60, no. 6, 2004, pp. 567-77.
Kłosiewicz-Latoszek L, Szostak WB, Grzybowska B, et al. Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia. Kardiol Pol. 2004;60(6):567-77.
Kłosiewicz-Latoszek, L., Szostak, W. B., Grzybowska, B., Białobrzeska-Paluszkiewicz, J., Wiśniewska, B., & Stolarska, I. (2004). Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia. Kardiologia Polska, 60(6), pp. 567-77.
Kłosiewicz-Latoszek L, et al. Comparison of Combined Statin-fibrate Treatment to Monotherapy in Patients With Mixed Hyperlipidemia. Kardiol Pol. 2004;60(6):567-77. PubMed PMID: 15334157.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of combined statin-fibrate treatment to monotherapy in patients with mixed hyperlipidemia. AU - Kłosiewicz-Latoszek,Longina, AU - Szostak,Wiktor B, AU - Grzybowska,Barbara, AU - Białobrzeska-Paluszkiewicz,Janina, AU - Wiśniewska,Beata, AU - Stolarska,Irena, PY - 2004/8/31/pubmed PY - 2004/11/17/medline PY - 2004/8/31/entrez SP - 567 EP - 77 JF - Kardiologia polska JO - Kardiol Pol VL - 60 IS - 6 N2 - BACKGROUND: Statins are the preferred drugs for the treatment of hypercholesterolemia, and fibrates for hypertriglyceridemia. In patients with mixed hyperlipidemia, monotherapy with one of these agents may not be effective and combined treatment may be preferable. AIM: To compare retrospectively the efficacy and safety of combined statin-fibrate treatment in patients with mixed hyperlipidemia in whom previous monotherapy with one of these agents occurred ineffective. METHODS AND RESULTS: The initial study group consisted of 327 patients who received micronised fenofibrate and 93 patients who received simvastatin for 12 months. Both agents caused significant changes in lipid profile. Following fibrate therapy, total cholesterol (TC), LDL-cholesterol (LDL-C) and triglyceride (TG) levels decreased by 27.9%, 28.2% and 58%, respectively, and following simvastatin therapy by 33.6%, 42.8% and 37.5%, respectively. The HDL-cholesterol (HDL-C) level increased after fenofibrate by 14.8% and remained unchanged following simvastatin therapy. The TC/HDL-C ratio decreased following fenofibrate by 35.6%, and following simvastatin by 35.3%. In some patients the required reduction in lipid parameters was not achieved fenofibrate or simvastatin. Subsequently, 93 patients underwent combined therapy by adding a second agent (simvastatin in a dose of 20 mg/day or fenofibrate in a dose of 200 mg per day) which was continued for another 12 months. The addition of simvastatin to fenofibrate decreased TC, LDL-C and TG levels by 35.5%, 42.1% and 59.6%, respectively in comparison to before treatment volumes. HDL-C level was increased by 11.1%, and TC/HDL-C ratio decreased by 45.3%. The addition of fenofibrate to simvastatin decreased TC, LDL-C and TG levels by 39.3%, 48.9% and 51,6%, respectively. HDL-C level was increased by 13.4%, and TC/HDL-C ratio decreased by 49.3%. No clinical side effects nor an increase in the transaminase levels, requiring termination of the treatment, were observed. CONCLUSIONS: Combined therapy with 20 mg of simvastatin and 200 mg of micronised fenofibrate is highly effective and safe in patients with mixed hyperlipidemia. SN - 0022-9032 UR - https://www.unboundmedicine.com/medline/citation/15334157/Comparison_of_combined_statin_fibrate_treatment_to_monotherapy_in_patients_with_mixed_hyperlipidemia_ L2 - https://medlineplus.gov/cholesterolmedicines.html DB - PRIME DP - Unbound Medicine ER -