Hye Duck Choi1, Wan Gyoon Shin2, Ju-Yeun Lee3, Byoung Cheol Kang2. 1. College of Pharmacy, Yeungnam University, Gyeongsangbuk-do 712-749, Republic of Korea. Electronic address: chd80@hotmail.com. 2. College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, San 56-1, Sillim-Dong, Gwanak-Gu, Seoul 151-742, Republic of Korea. 3. College of Pharmacy, Hanyang University, Gyeonggi-do 426-791, Republic of Korea.
Abstract
BACKGROUND: Dyslipidemia is a major risk factor for the development of cardiovascular disease. Treatment with fibrate, statins, or other lipid-lowering drugs prevents primary or recurrent cardiovascular events. However, all lipid-lowering drugs have side effects, which may become more severe if combination therapy is prescribed. METHODS: We performed a meta-analysis of published data to compare the safety and efficacy of fibrates alone, compared to fibrate-statin combinations, in patients with dyslipidemia. Six articles were assessed in terms of the efficacy of therapy and nine from the viewpoint of therapeutic safety. RESULTS: In terms of efficacy, fibrate-statin combinations afforded significantly greater reductions in the levels of total cholesterol (SE=-2.248; 95% CI 1.986-2.510), LDL cholesterol (SE=-2.274; 95% CI 2.015-2.533), and triglycerides (SE=-0.465; 95% CI 0.272-0.658) compared to fibrate alone. In terms of safety, treatment with fibrate alone was associated with a significant decrease in the number of kidney-related adverse events (RR=-0.547; 95% CI 0.368-0.812), compared to treatment with fibrate-statin combinations. CONCLUSION: We suggest that treatment with a fibrate-statin combination affords clinical benefits that are superior to treatment with fibrate alone, but increases the risk of side effects (particularly renal). Therapy should thus be carefully monitored.
BACKGROUND:Dyslipidemia is a major risk factor for the development of cardiovascular disease. Treatment with fibrate, statins, or other lipid-lowering drugs prevents primary or recurrent cardiovascular events. However, all lipid-lowering drugs have side effects, which may become more severe if combination therapy is prescribed. METHODS: We performed a meta-analysis of published data to compare the safety and efficacy of fibrates alone, compared to fibrate-statin combinations, in patients with dyslipidemia. Six articles were assessed in terms of the efficacy of therapy and nine from the viewpoint of therapeutic safety. RESULTS: In terms of efficacy, fibrate-statin combinations afforded significantly greater reductions in the levels of total cholesterol (SE=-2.248; 95% CI 1.986-2.510), LDL cholesterol (SE=-2.274; 95% CI 2.015-2.533), and triglycerides (SE=-0.465; 95% CI 0.272-0.658) compared to fibrate alone. In terms of safety, treatment with fibrate alone was associated with a significant decrease in the number of kidney-related adverse events (RR=-0.547; 95% CI 0.368-0.812), compared to treatment with fibrate-statin combinations. CONCLUSION: We suggest that treatment with a fibrate-statin combination affords clinical benefits that are superior to treatment with fibrate alone, but increases the risk of side effects (particularly renal). Therapy should thus be carefully monitored.
Authors: Abel A Pavía-López; Marco A Alcocer-Gamba; Edith D Ruiz-Gastelum; José L Mayorga-Butrón; Roopa Mehta; Filiberto A Díaz-Aragón; Jorge A Aldrete-Velasco; Nitzia López-Juárez; Ivette Cruz-Bautista; Adolfo Chávez-Mendoza; Nikos C Secchi-Nicolás; Francisco J Guerrero-Martínez; Jorge E Cossio-Aranda; Victoria Mendoza-Zubieta; Guillermo Fanghänel-Salmon; Martha Valdivia-Proa; Luis Olmos-Domínguez; Carlos A Aguilar-Salinas; Luis Dávila-Maldonado; Armando Vázquez-Rangel; Vanina Pavia-Aubry; María de Los A Nava-Hernández; Carlos A Hinojosa-Becerril; Juan C Anda-Garay; Manuel O de Los Ríos-Ibarra; Ana C Berni-Betancourt; Julio López-Cuellar; Diego Araiza-Garaygordobil; Romina Rivera-Reyes; Gabriela Borrayo-Sánchez; Mónica Tapia-Hernández; Claudia V Cano-Nigenda; Arturo Guerra-López; Josué Elías-López; Marco A Figueroa-Morales; Bertha B Montaño-Velázquez; Liliana Velasco-Hidalgo; Ana L Rodríguez-Lozano; Claudia Pimentel-Hernández; María M Baquero-Hoyos; Felipe Romero-Moreno; Mario Rodríguez-Vega Journal: Arch Cardiol Mex Date: 2022