title: Combined treatment with fibrates and small doses of atorvastatin in patients with mixed hyperlipidemia.
abstract: Combined statin and fibrate therapy is often imperative for the improvement of the serum lipid profile in patients with mixed hyperlipidemia. However, the potential risk of myopathy has limited the widespread use of such therapy. Preferably this treatment should involve low optimally tolerable doses of hypolipidemic drugs. Thus, we undertook a study to determine the safety and efficacy of combination therapy with fibrates and small doses of atorvastatin. Twenty-two patients with mixed hyperlipidemia were started on a fibrate regimen (micronised fenofibrate 200mg/day or ciprofibrate 100 mg/day). Because after 12 weeks of therapy the fibrate failed to normalise the serum lipid profile, small doses of atorvastatin (5 mg/day) were added for a further 12 weeks. The administration of the fibrates resulted in a significant decrease in total and LDL-cholesterol levels, as well as in triglycerides, and an increase in HDL-cholesterol levels. The addition of atorvastatin (5 mg/day) resulted in a further decrease in total and LDL-cholesterol levels. Consequently, the hypolipidemic therapy target was achieved in most of the patents. Combination therapy was well tolerated and no significant increases in serum liver and muscle enzymes were noticed. We conclude that the careful administration of small doses of atorvastatin in patients with mixed dyslipidemia receiving fibrates is associated with a significant amelioration of lipid abnormalities.
authors.affiliation: Department of Internal Medicine, University of Ioannina, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Liamis
authors.forename: Anna
authors.initials: A
authors.lastname: Kakafika
authors.forename: Eleni
authors.initials: E
authors.lastname: Bairaktari
authors.forename: George
authors.initials: G
authors.lastname: Miltiadous
authors.forename: Vasilios
authors.initials: V
authors.lastname: Tsimihodimos
authors.forename: John
authors.initials: J
authors.lastname: Goudevenos
authors.forename: Apostolos
authors.initials: A
authors.lastname: Achimastos
authors.forename: Moses
authors.initials: M
authors.lastname: Elisaf
mesh_terms: D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000069059:Atorvastatin; D002995:Clofibric Acid / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000627:therapeutic use*; D058607:Fibric Acids; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D006954:Hyperlipoproteinemia Type V / Q000097:blood / Q000188:drug therapy* / Q000201:enzymology; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008099:Liver / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D058607:Fibric Acids; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008055:Lipids; D011758:Pyrroles; D002995:Clofibric Acid; D000069059:Atorvastatin; C019304:ciprofibrate; D011345:Fenofibrate