Does the addition of fibrates to statin therapy have a favorable risk to benefit ratio?
Statins effectively lower low-density lipoprotein cholesterol levels and the risk of cardiovascular disease (CVD) events, and because of this they have become a standard treatment for dyslipidemia and atheroprevention. Unfortunately, statin monotherapy may fail to normalize high triglycerides and low high-density lipoprotein cholesterol, and it prevents only a minority of CVD events. Further treatment of lipid disorders that remain after statin monotherapy should help reduce the residual CVD risk. Fibrate monotherapy lowers high triglyceride levels, raises low high-density lipoprotein cholesterol, and reduces CVD risk; therefore, fibrates are recommended as an adjunct to statins for treatment of residual dyslipidemia and residual CVD risk. This review provides an update on the benefits and risks of fibrate monotherapy and addresses the benefits and risks of adding fibrates to statins.
Brinton
Eliot A
EA
Cardiovascular Genetics, University of Utah School of Medicine, 420 Chipeta Way, Room 1160, Salt Lake City, UT 84108, USA. eliot.brinton@utah.edu
D050197:Atherosclerosis / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D002995:Clofibric Acid / Q000627:therapeutic use*; D003925:Diabetic Angiopathies / Q000517:prevention & control; D004359:Drug Therapy, Combination; D011345:Fenofibrate / Q000494:pharmacology / Q000627:therapeutic use; D015248:Gemfibrozil / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012206:Rhabdomyolysis / Q000453:epidemiology; D018570:Risk Assessment; D014280:Triglycerides / Q000032:analysis
D008076:Cholesterol, HDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D014280:Triglycerides; D002995:Clofibric Acid; D015248:Gemfibrozil; D011345:Fenofibrate