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  • Title: Fibrate therapy in the management of dyslipidemias, alone and in combination with statins: role of delayed-release fenofibric acid.
    Author: Schima SM, Maciejewski SR, Hilleman DE, Williams MA, Mohiuddin SM.
    Journal: Expert Opin Pharmacother; 2010 Apr; 11(5):731-8. PubMed ID: 20210682.
    Abstract:
    IMPORTANCE OF THE FIELD: Optimization of lipid management is a crucial aspect in the treatment of cardiovascular disease. Currently, HMG-CO reductase inhibitors (statins) are a mainstay of therapy. While this class of drugs has proven efficacy at lowering low-density lipoprotein cholesterol (LDL-C), their effects on other important lipid parameters, such as high-density lipoprotein cholesterol (HDL-C) and triglycerides, are less robust. AREAS COVERED IN THIS REVIEW: The current paper will address the significance of these secondary targets and review currently available therapies, including a new formulation of delayed-release fenofibric acid. A comprehensive MEDLINE search (1966 to September 2009) was performed. WHAT THE READER WILL GAIN: The reader will gain a comprehensive review of the importance of secondary cholesterol targets, as well as the effectiveness of currently available therapies to address non-LDL-C. The role of the newly released fenofibric acid will also be addressed, as well as its potential use in combination therapy with a statin. TAKE HOME MESSAGE: Adequate treatment of lipid parameters beyond LDL-C is an essential component in the treatment of dyslipidemia. The fibrate class of drugs has proven efficacy in improving secondary targets; however, concerns regarding severe myopathy and rhabdomyolysis have limited their combination with statins. Recently, a new fibrate derivative, fenofibric acid, has become available. Studies to date reflect a positive safety and tolerability profile when combined with statins. This may offer a new tool to address the important secondary cholesterol targets that are becoming increasingly recognized as important contributors to cardiovascular outcomes.
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