OBJECTIVE: To evaluate the efficacy of fenofibrate, simvastatin or their combination in type 2 diabetic patients with combined dyslipidaemia. RESEARCH DESIGN AND METHODS: 241 patients, who had never previously taken lipid-lowering medications, receivedfenofibrate 145 mg/day, or simvastatin 40 mg/day, or fenofibrate 145 mg/day + simvastatin 40 mg/day combination for 12 months. We evaluated lipids, glycaemic, haemostatic, and inflammatory variables at baseline, and after 6 and 12 months. RESULTS: After 12 months total cholesterol (TC), LDL cholesterol (LDL-C) and triglycerides (Tg) decreased while HDL cholesterol (HDL-C) increased in all groups, even if the values obtained with fenofibrate + simvastatin were the best. At the end of the study apolipoprotein A-1 (Apo A-1) increased with fenofibrate + simvastatin, while apolipoprotein B (Apo B) decreased in all groups compared to baseline. Plasminogen activator inhibitor-1 (PAI-1) and high-sensitivity C reactive protein (hs-CRP) decreased after 12 months compared to baseline with simvastatin, and with fenofibrate + simvastatin even if the value obtained with fenofibrate-simvastatin was the lowest. After 12 months, fibrinogen (Fg) decreased compared to baseline with fenofibrate + simvastatin. LIMITATIONS: This study has some limitations. The first one is the relatively small sample of studied patients. The second one is the lack of an advanced lipid proteins evaluation, such as lipoprotein subfraction changes in the different treatment regimen. Finally, we have not selected patients that could show the best response to fibrate (i.e.: hypertriglyceridemics) or statins (i.e.: hypercholesterolemics) monotherapy, so the effect of these drugs administered alone may have been partly attenuated. CONCLUSIONS:Fenofibrate + simvastatin association improved lipid parameters, prothrombotic and inflammatory factors, and appeared to have a good tolerability profile over 12 months of therapy.
RCT Entities:
OBJECTIVE: To evaluate the efficacy of fenofibrate, simvastatin or their combination in type 2 diabeticpatients with combined dyslipidaemia. RESEARCH DESIGN AND METHODS: 241 patients, who had never previously taken lipid-lowering medications, received fenofibrate 145 mg/day, or simvastatin 40 mg/day, or fenofibrate 145 mg/day + simvastatin 40 mg/day combination for 12 months. We evaluated lipids, glycaemic, haemostatic, and inflammatory variables at baseline, and after 6 and 12 months. RESULTS: After 12 months total cholesterol (TC), LDL cholesterol (LDL-C) and triglycerides (Tg) decreased while HDL cholesterol (HDL-C) increased in all groups, even if the values obtained with fenofibrate + simvastatin were the best. At the end of the study apolipoprotein A-1 (Apo A-1) increased with fenofibrate + simvastatin, while apolipoprotein B (Apo B) decreased in all groups compared to baseline. Plasminogen activator inhibitor-1 (PAI-1) and high-sensitivity C reactive protein (hs-CRP) decreased after 12 months compared to baseline with simvastatin, and with fenofibrate + simvastatin even if the value obtained with fenofibrate-simvastatin was the lowest. After 12 months, fibrinogen (Fg) decreased compared to baseline with fenofibrate + simvastatin. LIMITATIONS: This study has some limitations. The first one is the relatively small sample of studied patients. The second one is the lack of an advanced lipid proteins evaluation, such as lipoprotein subfraction changes in the different treatment regimen. Finally, we have not selected patients that could show the best response to fibrate (i.e.: hypertriglyceridemics) or statins (i.e.: hypercholesterolemics) monotherapy, so the effect of these drugs administered alone may have been partly attenuated. CONCLUSIONS:Fenofibrate + simvastatin association improved lipid parameters, prothrombotic and inflammatory factors, and appeared to have a good tolerability profile over 12 months of therapy.
Authors: Burton E Sobel; Regina M Hardison; Saul Genuth; Maria M Brooks; Robert D McBane; David J Schneider; Richard E Pratley; Kurt Huber; Robert Wolk; Ashok Krishnaswami; Robert L Frye Journal: Circulation Date: 2011-07-18 Impact factor: 29.690
Authors: Michel Farnier; David Marcereuil; Sophie De Niet; Jean Ducobu; Armin Steinmetz; Kjetil Retterstøl; Leszek Bryniarski; Albert Császár; Francis Vanderbist Journal: Clin Drug Investig Date: 2012-04-01 Impact factor: 2.859
Authors: Jiatao Ye; James N Kiage; Donna K Arnett; Alfred A Bartolucci; Edmond K Kabagambe Journal: Diabetol Metab Syndr Date: 2011-09-22 Impact factor: 3.320
Authors: Gissette Reyes-Soffer; Colleen I Ngai; Laura Lovato; Wahida Karmally; Rajasekhar Ramakrishnan; Stephen Holleran; Henry N Ginsberg Journal: Diabetes Care Date: 2012-10-01 Impact factor: 19.112