Castaldo Richard S
Niagara Falls Memorial Medical Center, North Tonawanda, NY USA ; Internal Medicine, PO Box 37, Arcade, NY 14009 USA.
Drugs Ther Perspect. 2016;32:162-169. doi: 10.1007/s40267-016-0288-3. Epub 2016 Mar 8.
Patients receiving statin therapy for dyslipidaemia often require treatment with an additional agent to control triglyceride levels. Options for add-on therapy include fibrates and omega-3 fatty acids. This case series describes the effects of switching add-on therapy from fenofibrate to icosapent ethyl (the ethyl ester of the omega-3 fatty acid, eicosapentaenoic acid) on patient lipid profiles.
This was a retrospective analysis of patient records from a private medical practice in western New York. Statin-treated patients with dyslipidaemia who had been treated with fenofibrate and later switched to icosapent ethyl were selected for analysis. Lipid profiles before and after the switch to icosapent ethyl were compared.
The records of five patients were analysed. All patients had hypertension and were overweight, male, and at high cardiovascular risk. After the switch to icosapent ethyl (treatment duration 3.9-5.8 months), triglyceride levels decreased in four patients, and low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, and total cholesterol levels decreased in all patients. High-density lipoprotein levels increased in four patients. Icosapent ethyl was well tolerated.
Switching from fenofibrate to icosapent ethyl as add-on to a statin therapy due to clinical need may provide an option for patients to maintain or improve lipid parameters.
接受他汀类药物治疗血脂异常的患者通常需要加用其他药物来控制甘油三酯水平。加用治疗的选择包括贝特类药物和ω-3脂肪酸。本病例系列描述了将加用治疗从非诺贝特转换为二十碳五烯酸乙酯（ω-3脂肪酸二十碳五烯酸的乙酯）对患者血脂谱的影响。
这是一项对纽约西部一家私人医疗诊所患者记录的回顾性分析。选择接受他汀类药物治疗的血脂异常患者，这些患者曾接受非诺贝特治疗，后来转换为二十碳五烯酸乙酯进行分析。比较转换为二十碳五烯酸乙酯前后的血脂谱。
分析了5例患者的记录。所有患者均患有高血压，超重，为男性，且心血管风险高。转换为二十碳五烯酸乙酯后（治疗持续时间3.9 - 5.8个月），4例患者的甘油三酯水平下降，所有患者的低密度脂蛋白胆固醇、非高密度脂蛋白胆固醇和总胆固醇水平均下降。4例患者的高密度脂蛋白水平升高。二十碳五烯酸乙酯耐受性良好。
因临床需要将加用治疗从非诺贝特转换为二十碳五烯酸乙酯作为他汀类药物治疗的补充，可能为患者维持或改善血脂参数提供一种选择。
