Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both?

<p>Abstract</p> <p>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 ongo...

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Main Authors: Tenenbaum Alexander, Fisman Enrique Z
Format: Article
Language:English
Published: BMC 2004-12-01
Series:Cardiovascular Diabetology
Subjects:
Online Access:http://www.cardiab.com/content/3/1/10
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author Tenenbaum Alexander
Fisman Enrique Z
author_facet Tenenbaum Alexander
Fisman Enrique Z
author_sort Tenenbaum Alexander
collection DOAJ
description <p>Abstract</p> <p>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.</p> <p>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.</p> <p>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.</p>
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spelling doaj.art-80e239fa1fc64ac0acae774797a9429c2022-12-21T21:48:56ZengBMCCardiovascular Diabetology1475-28402004-12-01311010.1186/1475-2840-3-10Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both?Tenenbaum AlexanderFisman Enrique Z<p>Abstract</p> <p>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.</p> <p>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.</p> <p>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.</p>http://www.cardiab.com/content/3/1/10Diabetes mellitusDyslipidemiaFibratesMetabolic syndromeStatins
spellingShingle Tenenbaum Alexander
Fisman Enrique Z
Which is the best lipid-modifying strategy in metabolic syndrome and diabetes: fibrates, statins or both?
Cardiovascular Diabetology
Diabetes mellitus
Dyslipidemia
Fibrates
Metabolic syndrome
Statins
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 Diabetes mellitus
Dyslipidemia
Fibrates
Metabolic syndrome
Statins
url http://www.cardiab.com/content/3/1/10
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AT fismanenriquez whichisthebestlipidmodifyingstrategyinmetabolicsyndromeanddiabetesfibratesstatinsorboth