Tziomalos Konstantinos, Athyros Vasilios G
Atherosclerosis and Metabolic Syndrome Units, 2nd Prop. Department of Internal Medicine, Aristotelian University, Hippokration Hospital, Thessaloniki, Greece.
Int J Nanomedicine. 2006;1(2):129-47. doi: 10.2147/nano.2006.1.2.129.
Cardiovascular disease is the major cause of mortality worldwide and accounts for approximately 40% of all deaths. Dyslipidemia is one of the primary causes of atherosclerosis and effective interventions to correct dyslipidemia should form an integral component of any strategy aimed at preventing cardiovascular disease. Fibrates have played a major role in the treatment of hyperlipidemia for more than two decades. Fenofibrate is one of the most commonly used fibrates worldwide. Since fenofibrate was first introduced in clinical practice, a major drawback has been its low bioavailability when taken under fasting conditions. Insoluble Drug Delivery-Microparticle fenofibrate is a new formulation that has an equivalent extent of absorption under fed or fasting conditions. In this review, we will discuss the clinical pharmacology of fenofibrate, with particular emphasis on this novel formulation, as well as its lipid-modulating and pleiotropic actions. We will also analyze the major trial that evaluated fibrates for primary and secondary prevention of cardiovascular disease, the safety and efficacy profile of fibrate-statin combination treatment, and the current recommendations regarding the use of fibrates in clinical practice.
心血管疾病是全球主要的死亡原因,约占所有死亡人数的40%。血脂异常是动脉粥样硬化的主要原因之一,纠正血脂异常的有效干预措施应成为任何预防心血管疾病策略的重要组成部分。二十多年来,贝特类药物在高脂血症治疗中发挥了重要作用。非诺贝特是全球最常用的贝特类药物之一。自非诺贝特首次应用于临床实践以来,一个主要缺点是在空腹条件下服用时生物利用度较低。不溶性药物递送微粒非诺贝特是一种新剂型,在进食或空腹条件下具有同等程度的吸收。在本综述中,我们将讨论非诺贝特的临床药理学,特别强调这种新型剂型,以及其调脂作用和多效性作用。我们还将分析评估贝特类药物用于心血管疾病一级和二级预防的主要试验、贝特类药物与他汀类药物联合治疗的安全性和有效性概况,以及目前关于在临床实践中使用贝特类药物的建议。