Fibrate Plus a Statin Effective for Combined Hyperlipidemia

Results of a new study provide more evidence, in a larger population of patients, that the combination of a fibrate and a statin is an effective therapeutic option for managing combined hyperlipidemia — that is, elevated triglycerides and LDL-C and multiple lipoprotein abnormalities. In a randomized, double-blind, active-controlled 18-week study, investigators compared the effects of simvastatin monotherapy (20 mg/day) with a combination of simvastatin 20 mg plus fenofibrate 160 mg/day in 618 adults 21 to 68 years of age with combined hyperlipidemia. Most of the patients also had the metabolic syndrome.

Adding fenofibrate to simvastatin improved the lipid profile compared with simvastatin alone, Dr. Scott M. Grundy from UT Southwestern Medical Center at Dallas and colleagues report in the February 15th American Journal of Cardiology.

Compared with simvastatin alone, the combination of simvastatin and fenofibrate further lowered triglycerides and VLDL-C by 23.6% and 25.1%, respectively, and raised HDL-C by 18.6% compared with baseline. The increase in HDL-C with combination therapy was twice that observed with solo simvastatin.

The fibrate/statin combination also produced significantly greater reductions in LDL-C, non-HDL, total cholesterol, and apolipoprotein B compared with simvastatin monotherapy. Combination therapy was well tolerated.

"The present trial provides robust data on the efficacy and safety of combination therapy with a moderate dose of simvastatin and fenofibrate in patients with combined hyperlipidemia," the investigators conclude.

These findings support an earlier study by the UT Southwestern team involving 20 adults with combined hyperlipidemia.
Am J Cardiol 2005;95:462-468.
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FACT:
Beta-Cell Dysfunction Implicated in Low Birth Weight-Related Diabetes:
Findings from a study suggest that primary beta-cell dysfunction plays a key role in the pathogenesis of low birth weight (LBW)-associated type 2 diabetes.
It seems that the condition involves hyperinsulinism, without peripheral insulin resistance. Diabetes March, 2005.