Item
#6
Effectivness
of Fenofibrate + Atorvastatin in Type 2’s
The
atorvastatin-fenofibrate combination reduced total
cholesterol by 37%, LDL cholesterol by 46%, TGs by 50%
This
study evaluated the effect of a atorvastatin-fenofibrate combination
on lipid profile, in comparison to each drug alone, in
patients with type 2 diabetes and combined hyperlipidemia (CHL).
A
total of 120 consecutive patients, who were free of
coronary artery disease (CAD) at entry, were studied for a
period of 24 weeks. These patients were randomly assigned
to atorvastatin (20 mg/day, n = 40), micronized
fenofibrate (200 mg/day, n = 40), or a combination of
both (atorvastatin 20 mg/day plus fenofibrate 200 mg/day, n
= 40). The effect of treatment on LDL cholesterol, triglycerides (TGs),
HDL cholesterol, apolipoprotein A-I and B, lipoprotein(a), and
plasma fibrinogen (PF) was recorded. Moreover, the percentage of
patients that reached the American Diabetes Association treatment
goals and the estimated CAD risk status were calculated.
The
results showed that no patient was withdrawn from the study because
of side effects. The atorvastatin-fenofibrate combination
reduced total cholesterol by 37%, LDL cholesterol by 46%,
TGs by 50%, and PF by 20%, whereas it increased HDL
cholesterol by 22% (P < 0.0001 for all). These
changes were significantly better than those of both
monotherapies. Of the patients on drug combination, 97.5%
reached the LDL cholesterol treatment goal of <100 mg/dl,
100% reached the desirable TG levels of <200 mg/dl, and
60% reached the optimal HDL cholesterol levels of >45 mg/dl.
These rates were significantly higher than those of both monotherapies.
Combined treatment reduced the 10-year probability for
myocardial infarction from 21.6 to 4.2%.
In
conclusion, the atorvastatin-fenofibrate combination has a
highly beneficial effect on all lipid parameters and PF in patients
with type 2 diabetes and CHL. It improved patients’ CAD
risk status significantly more than each drug alone. Diabetes
Care 25:1198-1202, 2002
