Turk Kardiyol Dern Ars. 2005; 33(3): 170-176

Statin-fibrate combination therapy

Hüsniye Yüksel¹

Statins and fibrates are two diverse groups of antilipemic drugs with different mechanisms of action and metabolism. Statins are the most effective drugs in lowering low-density lipoprotein (LDL) cholesterol levels. Fibrates decrease triglyceride-rich lipoprotein and atherogenic small-dense LDL levels while increasing the level of high-density lipoprotein (HDL). However, monotherapies with statins or fibrates may not always improve the lipid profile of patients with combined hyperlipidemia, which includes diabetes and metabolic syndrome, and hereditary primary severe hypercholesterolemia. In these situations, statin-fibrate combination therapy seems attractive because of their complementary actions on lipoprotein metabolism. Combination therapy has been reported to be very effective in lowering both triglyceride and LDL cholesterol levels. However, early reports of increased incidence of myopathy and rhabdomyolysis in patients treated with statin-fibrate combination have been somewhat discouraging. More recent studies have shown that the occurrence of myopathy is less than expected. In this paper, the role of combined statin-fibrate therapy in dyslipidemia, their mechanisms of action, efficacy and safety of statin-fibrate combination therapy, and precautions needed to be taken to reduce side effects are reviewed in the light of literature.

Keywords: Anticholesteremic agents/therapeutic use; antilipemic agents/therapeutic use; creatinine/blood; drug therapy, combination; hyperlipidemia/drug therapy; lipids/blood; triglycerides/blood

---

CITE