Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY 40213 USA.
J Clin Lipidol. 2008 Dec;2(6):426-35. doi: 10.1016/j.jacl.2008.10.001. Epub 2008 Nov 12.
Co-administration of a fibrate and statin is an effective treatment option for patients with multiple lipid abnormalities, yet adequate long-term safety and efficacy data are lacking.
To evaluate the long-term safety and efficacy of fenofibric acid combined with statins in adults with mixed dyslipidemia.
Three large, 12-week, phase three, double-blind, randomized, controlled trials evaluated fenofibric acid 135 mg combined with a low- or moderate-dose statin compared to fenofibric acid or statin monotherapy, and a subsequent 52-week open-label extension study evaluated fenofibric acid 135 mg combined with moderate-dose statin (rosuvastatin 20 mg, simvastatin 40 mg, or atorvastatin 40 mg). This prespecified analysis integrated results from these studies to assess the long-term safety and efficacy of combination therapy.
Across the controlled studies and the extension study, 2201 patients received at least one dose of fenofibric acid + statin for a median duration of 364 days. The most common adverse events were headache, upper respiratory tract infection, nasopharyngitis, and back pain, with the incidence of all adverse events being similar across all combination therapy treatment groups. Rhabdomyolysis or treatment-related death was not reported in any group. Combination therapy resulted in sustained improvements in multiple lipid parameters, including triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, very low-density lipoprotein cholesterol, total cholesterol, apolipoprotein B, and high-sensitivity C-reactive protein.
Long-term fenofibric acid + statin combination therapy was generally well tolerated and resulted in comprehensive and sustained improvements in multiple lipid parameters in adults with mixed dyslipidemia.
贝特类药物与他汀类药物联合使用是治疗多种血脂异常患者的有效治疗选择,但缺乏充分的长期安全性和疗效数据。
评估非诺贝特酸联合他汀类药物治疗混合性血脂异常成人患者的长期安全性和疗效。
三项大型、12 周、三期、双盲、随机、对照临床试验评估了非诺贝特酸 135mg 联合低剂量或中剂量他汀类药物与非诺贝特酸或他汀类药物单药治疗的疗效,随后进行了一项 52 周的开放性标签扩展研究,评估了非诺贝特酸 135mg 联合中剂量他汀类药物(瑞舒伐他汀 20mg、辛伐他汀 40mg 或阿托伐他汀 40mg)的疗效。本预先设定的分析整合了这些研究的结果,以评估联合治疗的长期安全性和疗效。
在对照研究和扩展研究中,2201 例患者接受了至少一剂非诺贝特酸+他汀类药物治疗,中位治疗时间为 364 天。最常见的不良反应是头痛、上呼吸道感染、鼻咽炎和背痛,所有联合治疗组的不良反应发生率相似。任何组均未报告横纹肌溶解或与治疗相关的死亡。联合治疗可持续改善多种血脂参数,包括甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇、极低密度脂蛋白胆固醇、总胆固醇、载脂蛋白 B 和高敏 C 反应蛋白。
长期非诺贝特酸+他汀类药物联合治疗总体耐受性良好,可全面持续改善混合性血脂异常成人患者的多种血脂参数。