McKenney James M, Farnier Michel, Lo Kwok-Wing, Bays Harold E, Perevozkaya Inna, Carlson Gary, Davies Michael J, Mitchel Yale B, Gumbiner Barry
National Clinical Research Inc., Richmond, Virginia 23294, USA.
J Am Coll Cardiol. 2006 Apr 18;47(8):1584-7. doi: 10.1016/j.jacc.2005.11.072. Epub 2006 Mar 30.
This study sought to determine the long-term safety and efficacy of co-administered fenofibrate (FENO) and ezetimibe (EZE) in patients with mixed hyperlipidemia.
Both EZE and FENO offer complementary benefits to the lipid profile of patients with mixed hyperlipidemia.
After completing the 12-week randomized, double-blind base study that compared EZE 10 mg, FENO 160 mg, FENO 160 mg plus EZE 10 mg, and placebo in patients with mixed hyperlipidemia, patients continued into a double-blind, 48-week extension phase. Those patients in the FENO plus EZE and FENO groups continued on their respective base study treatment, and patients in the EZE and placebo groups were switched to FENO plus EZE and FENO, respectively.
Of the 587 patients who completed the base study, 576 continued into the extension study (n = 340 in FENO plus EZE and n = 236 in FENO). The FENO plus EZE produced significantly greater reductions in low-density lipoprotein-cholesterol compared with FENO (-22% vs. -9%, respectively; p < 0.001). There were also significantly greater improvements in triglycerides, high-density lipoprotein cholesterol (HDL-C), total cholesterol, non-HDL-C, and apolipoprotein B with FENO plus EZE compared with FENO. Changes in apolipoprotein A-I and high-sensitivity C-reactive protein were similar between groups. Overall, FENO plus EZE was well tolerated during the extension study. The proportion of patients with consecutive elevations of alanine aminotransferase/aspartate aminotransferase > or =3 times upper limit of normal were similar between the FENO plus EZE (1.2%) and FENO (1.7%) groups. No cases of creatine phosphokinase elevations > or =10 times upper limit of normal or myopathy were observed in either group.
Long-term, 48-week co-administration of FENO plus EZE was well tolerated and more efficacious than FENO in patients with mixed hyperlipidemia.
本研究旨在确定联合使用非诺贝特(FENO)和依折麦布(EZE)治疗混合性高脂血症患者的长期安全性和疗效。
EZE和FENO对混合性高脂血症患者的血脂谱均有互补益处。
在完成一项为期12周的随机、双盲基础研究后,该研究比较了10毫克EZE、160毫克FENO、160毫克FENO加10毫克EZE以及安慰剂在混合性高脂血症患者中的疗效,患者继续进入双盲、为期48周的延长期。FENO加EZE组和FENO组的患者继续接受各自基础研究阶段的治疗,而EZE组和安慰剂组的患者分别换用FENO加EZE和FENO。
在完成基础研究的587例患者中,576例继续进入延长期研究(FENO加EZE组340例,FENO组236例)。与FENO相比,FENO加EZE使低密度脂蛋白胆固醇降低幅度显著更大(分别为-22%和-9%;p<0.001)。与FENO相比,FENO加EZE在甘油三酯、高密度脂蛋白胆固醇(HDL-C)、总胆固醇、非HDL-C和载脂蛋白B方面也有显著更大的改善。两组间载脂蛋白A-I和高敏C反应蛋白的变化相似。总体而言,在延长期研究中FENO加EZE耐受性良好。FENO加EZE组(1.2%)和FENO组(1.7%)中丙氨酸氨基转移酶/天冬氨酸氨基转移酶连续升高>或=正常上限3倍的患者比例相似。两组均未观察到肌酸磷酸激酶升高>或=正常上限10倍或肌病的病例。
在混合性高脂血症患者中,FENO加EZE长期(48周)联合使用耐受性良好,且比FENO更有效。