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Management of mixed dyslipidemia in patients with or at risk for cardiovascular disease: a role for combination fibrate therapy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Fazio, Sergio
Abstract	BACKGROUND: Lowering low-density lipoprotein cholesterol (LDL-C) is the primary focus of the management of dyslipidemia in patients with or at risk for cardiovascular disease. However, use of a statin alone may be insufficient for the treatment of mixed dyslipidemia, which is characterized by low levels of high-density lipoprotein cholesterol and elevated levels of triglycerides, with or without elevated levels of LDL-C. OBJECTIVE: This report reviews the evidence for the efficacy and tolerability of different combination treatments for the management of mixed dyslipidemia, as supported by clinical-trial data and recommended by national guidelines. METHODS: Using the terms lipid-modifying therapy, combination therapy, combination statin-fibrate therapy, and mixed dyslipidemia, a search of PubMed was conducted (completed in April 2007, updated to October 2007) to identify English-language publications and pertinent studies of fibrate combination therapy in patients with mixed dyslipidemia, including those with diabetes or the metabolic syndrome. RESULTS: National guidelines recommend the addition of either niacin (nicotinic acid) or a fibrate to statin therapy in patients with mixed dyslipidemia to achieve better overall lipid control. Fibrates do not have detrimental effects on uric acid levels or glycemic control in patients with diabetes or the metabolic syndrome. Based on data from the US Food and Drug Administration Adverse Event Reporting System indicating that gemfibrozil plus a statin was associated with a 15-fold higher risk of rhabdomyolysis than fenofibrate plus a statin, fenofibrate may be the fi-brate of choice for use in combination with a statin. As reported by the Fenofibrate Intervention and Event Lowering in Diabetes study, fenofibrate treatment has also been associated with microvascular benefits in patients with type 2 diabetes, which is consistent with preliminary evidence from the Diabetes Atherosclerosis Intervention Study. CONCLUSION: The addition of fenofibrate to statin therapy may be a useful strategy for the management of mixed dyslipidemia in patients with or at risk for cardiovascular disease.
File Format	HTM / HTML
ISSN	01492918
Issue Number	2
Volume Number	30
e-ISSN	1879114X
Journal	Clinical Therapeutics
Language	English
Publisher	Elsevier
Publisher Date	2008-02-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Pharmacology Cardiovascular Diseases Prevention & Control Clofibric Acid Therapeutic Use Dyslipidemias Drug Therapy Hydroxymethylglutaryl-coa Reductase Inhibitors Hypolipidemic Agents Etiology Adverse Effects Drug Therapy, Combination Complications Evidence-based Medicine Guideline Adherence Humans Practice Guidelines As Topic Risk Assessment Risk Factors Treatment Outcome Journal Article Research Support, Non-u.s. Gov't Review
Content Type	Text
Resource Type	Article
Subject	Pharmacology Pharmacology (medical)

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Combined therapy in the treatment of dyslipidemia.

Drug therapy of diabetic dyslipidemia: do the statins suffice?

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Fibrate therapy in the management of dyslipidemias, alone and in combination with statins: role of delayed-release fenofibric acid.

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CEPHEUS Trial.

Management of mixed dyslipidemia in patients with or at risk for cardiovascular disease: a role for combination fibrate therapy.

Similar Documents

Combined therapy in the treatment of dyslipidemia.

Drug therapy of diabetic dyslipidemia: do the statins suffice?

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Lipid-lowering agents and new onset diabetes mellitus.

Statin-fibrate combination for mixed dyslipidaemia: a limited option?

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Management of mixed dyslipidemia in patients with or at risk for cardiovascular disease: a role for combination fibrate therapy.