CONCOMITANT ADMINISTRATION OF STATIN AND FENOFIBRATE IN PATIENTS WITH MIXED DYSLIPIDEMIA

Background: Mixed dyslipidemia is present in 75% of the Czech population. The Czech Institute of Metabolic Syndrome initiated a study concerning management of mixed dyslipidemia in patients with high risk of atherosclerotic vascular diseases by co- administration of statin and fenofibrate.

Methods: 81 patients (46 males and 35 females) aged 60 years (34 -83 y.) with high risk SCORE were selected according to the presence of 2 from 3 following criteria: fasting plasma LDL-chol ³2,5 mmol/L, TG>1,7 mmol/L, HDL-chol<1 mmol/L in males and <1,3 mmol/L in females. At the baseline visit non-pharmacological intervention was provided and atorvastatin 10 mg or simvastatin 20 mg plus fenofibrate 160 mg daily were prescribed. When elevated TG and/or reduced HDL-chol persisted after 3 months, daily dose of fenofibrate was increased to 267 mg, when LDL-chol was still high, statin dose was increased to 40 mg simvastatin or 20 mg atorvastatin. After next 3 months the final evaluation of the effectiveness and tolerability of combined therapy was analyzed.

Results: After 6 months of the combined therapy total chol was reduced by 20 % (5,76-4,62 mmol/L) and LDL-chol by 40% (3,54–2,53 mmol/L). Level of HDL-ch increased by 3% (1,13–1,16 mmol/L) and TG level was reduced by 40% (2,98–1,78 mmol/L). Tolerance of combined therapy was excellent; no myopathy occurred, creatinkinase and liver tests (ALT, AST) were not significantly changed.

Conclusion: Treatment of mixed dyslipidemia by combined therapy of statin and fenofibrate in patients with high cardiovascular risk was effective and tolerance was excellent.