Combination of fenofibrate with non-statin drug regimens.
OBJECTIVE
We present the available data on the effects of combined therapy of fenofibrate with drugs affecting lipid metabolism other than statins.


METHODS
We consider studies evaluating the effects of combined therapy of fenofibrate with bile acid sequestrants (BAS), ezetimibe, niacin, n-3 fatty acids, plant sterols, orlistat, rimonabant, metformin and glitazones.


RESULTS
Combination of BAS (especially colesevelam) with fenofibrate had additional effects on metabolic parameters in patients with mixed hyperlipidemia. Combination of ezetimibe with fenofibrate may be a useful approach to improve the overall lipid profile of patients with mixed hyperlipidemia. There is a further reduction in triglyceride levels when n-3 fatty acids are administered with fenofibrate in patients with severe hypertriglyceridemia. Combined fenofibrate and orlistat treatment further improves metabolic parameters in overweight/obese patients with metabolic syndrome. The fenofibrate/thiazolidinedione combination is an alternative for diabetic patients intolerant to statins, though differences exist between pioglitazone and rosiglitazone.


CONCLUSIONS
For patients who cannot tolerate statins there are useful combinations of fenofibrate with other drugs affecting lipid metabolism. These combinations improve several metabolic parameters, but more trials should be carried out to reach more robust conclusions about their effects on cardiovascular events.
Agouridis
A P
AP
Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Ioannina, Greece.
Filippatos
T D
TD
Derdemezis
C S
CS
Mikhailidis
D P
DP
Elisaf
M S
MS
D000818:Animals; D004359:Drug Therapy, Combination; D011345:Fenofibrate / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000503:physiopathology; D000960:Hypolipidemic Agents / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D050356:Lipid Metabolism / Q000187:drug effects; D024821:Metabolic Syndrome / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D009765:Obesity / Q000150:complications
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011345:Fenofibrate