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Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both?
Although less clinical intervention studies have been performed with fibrates than with statins, there are evidences indicating that fibrates may reduce risk of cardiovascular events. The potential clinical benefit of the fenofibrate will be specified by the ongoing Fenofibrate Intervention and Even...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2004
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC538252/ https://www.ncbi.nlm.nih.gov/pubmed/15574199 http://dx.doi.org/10.1186/1475-2840-3-10 |
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author | Tenenbaum, Alexander Fisman, Enrique Z |
author_facet | Tenenbaum, Alexander Fisman, Enrique Z |
author_sort | Tenenbaum, Alexander |
collection | PubMed |
description | Although less clinical intervention studies have been performed with fibrates than with statins, there are evidences indicating that fibrates may reduce risk of cardiovascular events. The potential clinical benefit of the fenofibrate will be specified by the ongoing Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, which rationale, methods and aims have been just published. Controlled clinical trials show similar or even greater cardiovascular benefits from statins-based therapy in patient subgroups with diabetes compared with overall study populations. Therefore, statins are the drug of first choice for aggressive lipid lowering actions and reducing risk of coronary artery disease in these patients. However, current therapeutic use of statins as monotherapy is still leaving many patients with mixed atherogenic dyslipidemia at high risk for coronary events. A combination statin/fibrate therapy may be often necessary to control all lipid abnormalities in patients with metabolic syndrome and diabetes adequately, since fibrates provide additional important benefits, particularly on triglyceride and HDL-cholesterol levels. Thus, this combined therapy concentrates on all the components of the mixed dyslipidemia that often occurs in persons with diabetes or metabolic syndrome, and may be expected to reduce cardiovascular morbidity and mortality. Safety concerns about some fibrates such as gemfibrozil may lead to exaggerate precautions regarding fibrate administration and therefore diminish the use of the seagents. However, other fibrates, such as bezafibrate and fenofibrate appear to be safer and better tolerated. We believe that a proper co-administration of statins and fibrates, selected on basis of their safety, could be more effective in achieving a comprehensive lipid control as compared with monotherapy. |
format | Text |
id | pubmed-538252 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2004 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-5382522004-12-19 Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? Tenenbaum, Alexander Fisman, Enrique Z Cardiovasc Diabetol Editorial Although less clinical intervention studies have been performed with fibrates than with statins, there are evidences indicating that fibrates may reduce risk of cardiovascular events. The potential clinical benefit of the fenofibrate will be specified by the ongoing Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study, which rationale, methods and aims have been just published. Controlled clinical trials show similar or even greater cardiovascular benefits from statins-based therapy in patient subgroups with diabetes compared with overall study populations. Therefore, statins are the drug of first choice for aggressive lipid lowering actions and reducing risk of coronary artery disease in these patients. However, current therapeutic use of statins as monotherapy is still leaving many patients with mixed atherogenic dyslipidemia at high risk for coronary events. A combination statin/fibrate therapy may be often necessary to control all lipid abnormalities in patients with metabolic syndrome and diabetes adequately, since fibrates provide additional important benefits, particularly on triglyceride and HDL-cholesterol levels. Thus, this combined therapy concentrates on all the components of the mixed dyslipidemia that often occurs in persons with diabetes or metabolic syndrome, and may be expected to reduce cardiovascular morbidity and mortality. Safety concerns about some fibrates such as gemfibrozil may lead to exaggerate precautions regarding fibrate administration and therefore diminish the use of the seagents. However, other fibrates, such as bezafibrate and fenofibrate appear to be safer and better tolerated. We believe that a proper co-administration of statins and fibrates, selected on basis of their safety, could be more effective in achieving a comprehensive lipid control as compared with monotherapy. BioMed Central 2004-12-01 /pmc/articles/PMC538252/ /pubmed/15574199 http://dx.doi.org/10.1186/1475-2840-3-10 Text en Copyright © 2004 Tenenbaum and Fisman; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Editorial Tenenbaum, Alexander Fisman, Enrique Z Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title | Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title_full | Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title_fullStr | Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title_full_unstemmed | Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title_short | Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
title_sort | which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both? |
topic | Editorial |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC538252/ https://www.ncbi.nlm.nih.gov/pubmed/15574199 http://dx.doi.org/10.1186/1475-2840-3-10 |
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