A comparative study of efficacy of atorvastatin alone and its combination with fenofibrate on lipid profile in type 2 diabetes mellitus patients with hyperlipidemia

Abstract

Mixed dyslipidemia is characterized by increased low-density lipoprotein cholesterol (LDL-C) elevated triglycerides (TGs) and decrease high-density lipoprotein cholesterol (HDL-C). It is more common in diabetes and is associated with an increased risk of coronary artery disease. Monotherapy with statins or fibrates may not effectively control all lipid parameters. The atorvastatin-fenofibrate combination has been shown to have highly beneficial effect on lipid parameters in type 2 diabetes associated with combined hyperlipidemia (CHL). In an open-label study, we evaluated the efficacy of atorvastatin alone and in combination with fenofibrate in 60 types 2 diabetes mellitus patients associated with hyperlipidemia. Patients were randomly assigned to receive atorvastatin 10 mg (Group 1) or combination of atorvastatin 10 mg and fenofibrate 145 mg (Group 2) once daily for 12 weeks. The effect of drugs on lipid profile was evaluated before and after treatment. After 12 weeks, the reduction in total cholesterol (TC), TGs, LDL-C, VLDL-C was 28%, 20%, 37% and 20% in Group 1 (P < 0.001 for all) as compared with 31%, 39%, 33% and 40% in Group 2 (P < 0.001 for all). There was insignificant rise in HDL-C in Group 1 (P = 0.71) and insignificant decrease in HDL-C (P = 0.70) in Group 2. During the combination therapy, the decrease in TC, TGs and VLDL-C was greater than atorvastatin alone. The combination of atorvastatin with fenofibrate in type 2 diabetes patients with CHL may have a favorable effect on some major coronary artery disease risk factors.

Fenofibrate suppressed proliferation and migration of human neuroblastoma cells via oxidative stress dependent of TXNIP upregulation

“…Fenofibrate, a PPAR-a agonist commonly used in the treatment for hyperlipidemia and hypercholesterolemia, has been recognized to exert anti-proliferative and pro-apoptotic effects in several tumor cell lines [4,7,8,10]. But it rarely reported its roles of fenofibrate in NB.…”

“…Fenofibrate has been used to treat different forms of hyperlipidemia and hypercholesterolemia [4]. Interestingly, recent studies show that fenofibrate may have antitumor effects by directly attenuating tumor growth.…”

Comparative Study of Atorvastatin and Rosuvastatin in Combination with Fenofibrate in mixed Hyperlipidemia

“…[24] The combination treatment had reduced LDL-C by 46%, TGs by 50%, TC by 37% and increased HDL-C by 46% and the changes are better than compared with monotherapy.…”

Obesity and Insulin Resistance: An Overview

“…Fibrates activate peroxisome proliferatoractivated receptors alpha (PPAR-alpha). They stimulate oxidation of fatty acids and therefore lower plasma levels of free fatty acids and triacylglycerol and increase HDL-c. Fibrates may also improve insulin sensitivity 28 . In addition, cholesterol absorption inhibitors, resins and niacin are available and may be used along with statins to reach the LDL goal or in the case of statin intolerance Hypertension Anti hypertensive are administered at the level of the 130/80 mmHg in diabetic patients.…”