Department of Medicine, Division of Cardiology, Creighton University School of Medicine, Omaha, NE 68131, USA.
Expert Opin Pharmacother. 2010 Apr;11(5):731-8. doi: 10.1517/14656560903575639.
Optimization of lipid management is a crucial aspect in the treatment of cardiovascular disease. Currently, HMG-CO reductase inhibitors (statins) are a mainstay of therapy. While this class of drugs has proven efficacy at lowering low-density lipoprotein cholesterol (LDL-C), their effects on other important lipid parameters, such as high-density lipoprotein cholesterol (HDL-C) and triglycerides, are less robust.
The current paper will address the significance of these secondary targets and review currently available therapies, including a new formulation of delayed-release fenofibric acid. A comprehensive MEDLINE search (1966 to September 2009) was performed.
The reader will gain a comprehensive review of the importance of secondary cholesterol targets, as well as the effectiveness of currently available therapies to address non-LDL-C. The role of the newly released fenofibric acid will also be addressed, as well as its potential use in combination therapy with a statin.
Adequate treatment of lipid parameters beyond LDL-C is an essential component in the treatment of dyslipidemia. The fibrate class of drugs has proven efficacy in improving secondary targets; however, concerns regarding severe myopathy and rhabdomyolysis have limited their combination with statins. Recently, a new fibrate derivative, fenofibric acid, has become available. Studies to date reflect a positive safety and tolerability profile when combined with statins. This may offer a new tool to address the important secondary cholesterol targets that are becoming increasingly recognized as important contributors to cardiovascular outcomes.
脂质管理的优化是一个重要方面的治疗心血管疾病。目前，羟甲基戊二酰辅酶 A 还原酶抑制剂（他汀类药物）是治疗的主要手段。虽然这类药物已被证明在降低低密度脂蛋白胆固醇（LDL-C）的疗效，他们对其他重要的脂质参数的影响，如高密度脂蛋白胆固醇（HDL-C）和甘油三酯，效果不那么强大。
目前的文件将解决这些次要目标的意义，并审查目前可用的治疗方法，包括延迟释放非诺贝特酸的新配方。全面的 MEDLINE 搜索（1966 年至 2009 年 9 月）进行了。
读者将获得一个全面的审查的重要性的次要胆固醇目标，以及目前可用的治疗方法来解决非 LDL-C。新发布的非诺贝特酸的作用也将被解决，以及其在与他汀类药物联合治疗中的潜在用途。
充分治疗脂质参数以外的 LDL-C 是治疗血脂异常的一个重要组成部分。纤维酸类药物已被证明在改善次要目标方面的疗效；然而，对严重肌病和横纹肌溶解的关注限制了他们与他汀类药物的联合应用。最近，一种新的纤维酸衍生物，非诺贝特酸，已经上市。目前的研究反映了与他汀类药物联合使用时具有良好的安全性和耐受性。这可能提供一个新的工具来解决越来越被认为是心血管结果的重要贡献者的重要的次要胆固醇目标。
