A retrospective assessment of the effectiveness of fenofibrate 267 mg on high-density lipoprotein cholesterol levels in patients attending a lipid clinic.
BACKGROUND
A high-density lipoprotein cholesterol level (HDL-C) <1 mmol/L is associated with increased cardiovascular morbidity and mortality. In clinical trials, fibrates have been shown to increase levels of HDL-C, with subsequent reduction in cardiovascular risk.


OBJECTIVE
This study evaluated the use of fenofibrate 267 mg/d in a routine lipid clinic setting to determine how much HDL-C could be increased in everyday clinical practice.


METHODS
Blood samples from patients who had taken fenofibrate 267 mg/d between 1998 and 2001 at the Lipid Clinic, Charing Cross Hospital, London, United Kingdom, were analyzed for changes in total cholesterol (TC), HDL-C, and triglycerides during follow-up.


RESULTS
Sixty-five consecutive patients (49 men, 16 women; mean age, 54 +/- 1.2 years) were included in the study. The follow-up period ranged from 1 to 36 months (mean, 9.6 months +/- 26.7 days). Patients achieved a 6% overall increase in HDL-C, from 0.91 +/- 0.03 mmol/L to 0.97 +/- 0.03 mmol/L (P = 0.016). The TC/HDL-C ratio decreased by 21% from 7.0 +/- 0.3 mmol/L to 5.5 +/- 0.2 mmol/L (P < 0.001). Patients with lower levels of HDL-C at baseline (<0.9 mmol/L) showed the most improvement, with an 8% increase (P < 0.05). Twenty-eight patients (43%) reached a target HDL-C posttherapy value >1.0 mmol/L. Thirty-nine patients (responders) had increases in their HDL-C levels; 26 patients (nonresponders) had decreases or no change in their HDL-C levels. For the 26 (40%) patients in whom HDL-C did not increase, the TC/HDL-C ratio decreased by 12% from 6.5 +/- 0.3 mmol/L to 5.7 +/- 0.3 mmol/L (P = 0.003).


CONCLUSIONS
Fenofibrate 267 mg/d is well tolerated and can achieve significant increases in HDL-C levels in clinical practice. However, these results should be confirmed in a larger routine clinical setting because of the discrepancies between the results of some clinical trials.
le Roux
Carel W
CW
Lipid Clinic, Charing Cross Hospital, London, United Kingdom. c.leroux@ic.ac.uk
Murphy
Elaine
E
Seed
Mary
M
D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D011345:Fenofibrate / Q000008:administration & dosage / Q000627:therapeutic use*; D006785:Hospitals, University; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000378:metabolism; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data; D018160:Receptors, Cytoplasmic and Nuclear / Q000819:agonists; D012189:Retrospective Studies; D014157:Transcription Factors / Q000819:agonists; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D008076:Cholesterol, HDL; D000960:Hypolipidemic Agents; D018160:Receptors, Cytoplasmic and Nuclear; D014157:Transcription Factors; D014280:Triglycerides; D011345:Fenofibrate