Does Combination Therapy with Statins and Fibrates Prevent Cardiovascular Disease in Diabetic Patients with Atherogenic Mixed Dyslipidemia?

Agouridis, Aris P.; Rizos, Christos V.; Elisaf, Moses; Filippatos, Theodosios D.

doi:10.1900/rds.2013.10.171

Cited by 31 publications

(16 citation statements)

References 209 publications

(129 reference statements)

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“…Adverse events are also consistent with the known safety profiles of both drugs; however, fenofibric acid plus atorvastatin is associated with a higher incidence of renal impairment as compared with atorvastatin monotherapy [142]. Although fibrates in combination with statins have a highly beneficial effect on almost all lipid parameters in patients with mixed dyslipidemia, this combination does not reach the desired non-HDL-C or TG and/or HDL-C concentrations [143]. Thus, a number of larger prospective studies are eagerly anticipated to further determine the role of statin/fibrate combination in reducing the risks of atherosclerosis-related diseases.…”

Section: Therapeutic Potential Of Pparα Agonists In Atherosclerosis Asupporting

confidence: 65%

Peroxisome Proliferator-Activated Receptor α in Lipid Metabolism and Atherosclerosis

Zheng

Tang

2015

Advances in Clinical Chemistry

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Section: Therapeutic Potential Of Pparα Agonists In Atherosclerosis Asupporting

confidence: 65%

Peroxisome Proliferator-Activated Receptor α in Lipid Metabolism and Atherosclerosis

Zheng

Tang

2015

Advances in Clinical Chemistry

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“…Various classes of drugs have proved useful in the management of patients with type 2 diabetes (T2D) and its complications [1,[5][6][7][8][9][10][11][12]. Recent evidence demonstrated the beneficial effects of incretin-mimetic drugs in the treatment of T2D; these drugs include glucagon-like peptide-1 (GLP-1) receptor agonists and dipeptidyl peptidase 4 (DPP-4) inhibitors [13,14].…”

Section: Introductionmentioning

confidence: 99%

Adverse Effects of GLP-1 Receptor Agonists

2014

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■ AbstractGlucagon-like peptide-1 (GLP-1) receptor agonists are a class of injective anti-diabetic drugs that improve glycemic control and many other atherosclerosis-related parameters in patients with type 2 diabetes (T2D). However, the use of this relatively new class of drugs may be associated with certain adverse effects. Concerns have been expressed regarding the effects of these drugs on pancreatic and thyroid tissue, since animal studies and analyses of drug databases indicate an association of GLP-1 receptor agonists with pancreatitis, pancreatic cancer, and thyroid cancer. However, several meta-analyses failed to confirm a cause-effect relation between GLP-1 receptor agonists and the development of these adverse effects. One benefit of GLP-1 receptor agonists is that they do not cause hypoglycemia when combined with metformin or thiazolidinediones, but the dose of concomitant sulphonylurea or insulin may have to be decreased to reduce the risk of hypoglycemic episodes. On the other hand, several case reports have linked the use of these drugs, mainly exenatide, with the occurrence of acute kidney injury, primarily through hemodynamic derangement due to nausea, vomiting, and diarrhea. The most common symptoms associated with the use of GLP-1 receptor agonists are gastrointestinal symptoms, mainly nausea. Other common adverse effects include injection site reactions, headache, and nasopharyngitis, but these effects do not usually result in discontinuation of the drug. Current evidence shows that GLP-1 receptor agonists have no negative effects on the cardiovascular risk of patients with T2D. Thus, GLP-1 receptor agonists appear to have a favorable safety profile, but ongoing trials will further assess their cardiovascular effects. The aim of this review is to analyze critically the available data regarding adverse events of GLP-1 receptor agonists in different anatomic systems published in Pubmed and Scopus. Whenever possible, certain differences between GLP-1 receptor agonists are described. The review also provides the reader with structured data that compare the rates of the most common adverse effects for each of the various GLP-1 receptor agonists.

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“…Concomitant use of statins and fibrates is believed to further increase the incidence of myalgia and muscle damage. [ 23 ] However, in our study concomitant use of fibrate with statin was found to be safe, and no increased incidence of muscle damage was reported. A meta-analysis which included six clinical trials and 1628 subjects reported no cases of myopathy or muscle damage but showed a significant increase in elevation of liver enzymes in statin-fibrate combination therapy when compared to statin monotherapy.…”

Section: Discussionmentioning

confidence: 50%

“…In such group of patients with below normal HDL-C and TG levels, addition of fibrates has been shown to provide additional benefit. [ 23 ] Other lipid parameters were also improved with use of both the drugs in the patients. Serum total cholesterol and very LDL-C levels were also reduced with use of both the drugs during the study period.…”

Section: Discussionmentioning

confidence: 98%

Comparison of efficacy and safety of choline fenofibrate (fenofibric acid) to micronized fenofibrate in patients of mixed dyslipidemia: A randomized, open-label, multicenter clinical trial in Indian population

Patel¹,

Barkate²

2016

Indian J Endocr Metab

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Introduction:Choline fenofibrate is a newly developed choline salt of fenofibric acid, which is more hydrophilic than fenofibrate. This study was initiated to evaluate the safety and efficacy of choline fenofibrate in comparison to micronized fenofibrate among Indian patients of mixed dyslipidemia.Methods:A multicenter, open-label, randomized, active controlled, comparative, parallel group study was conducted at around 10 centers spread all across the country. Mixed dyslipidemia patients (serum triglycerides [TG] levels between 150 and 500 mg/dl), aged 18–70 years and taking stable statin dose for 8 weeks were randomized to choline fenofibrate 135 mg delayed release tablets and micronized fenofibrate 160 mg tablets once daily for 12 weeks. The primary endpoint of the study was percentage change in serum TG level at the end of 12 weeks.Results:A total of 226 patients were enrolled in this study, of which 116 patients were administered choline fenofibrate and 110 patients were administered micronized fenofibrate. At the end of 12 weeks, there was a significant reduction in TG level (34.24% in choline fenofibrate group and 38.13% reduction in micronized fenofibrate group). However, the difference between group was not statistically different (P = 0.471). Similarly, there was a significant increase in high-density lipoprotein cholesterol at the end of 12 weeks (10% increase in choline fenofibrate group and 9% increase in micronized fenofibrate group); but the difference between the group was not statistically significant (P = 0.598). Both the treatment was safe and well tolerated.Conclusion:Choline fenofibrate delayed release 135 mg is as safe and effective as 160 mg of micronized fenofibrate in Indian patients with mixed dyslipidemia.

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Does Combination Therapy with Statins and Fibrates Prevent Cardiovascular Disease in Diabetic Patients with Atherogenic Mixed Dyslipidemia?

Cited by 31 publications

References 209 publications

Peroxisome Proliferator-Activated Receptor α in Lipid Metabolism and Atherosclerosis

Peroxisome Proliferator-Activated Receptor α in Lipid Metabolism and Atherosclerosis

Adverse Effects of GLP-1 Receptor Agonists

Comparison of efficacy and safety of choline fenofibrate (fenofibric acid) to micronized fenofibrate in patients of mixed dyslipidemia: A randomized, open-label, multicenter clinical trial in Indian population

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