Fenofibrate/Simvastatin Benefit in Dyslipidemia Explored

Combination treatment reduces triglycerides for all but atherogenic apoB48 only in dyslipidemic

WEDNESDAY, Oct. 31 (HealthDay News) -- Combination treatment with fenofibrate and simvastatin (FENO-S) significantly reduces postprandial (PP) triglyceride (TG) levels compared with simvastatin alone in all subjects, regardless of fasting TG level, but reduces atherogenic apolipoprotein (apo) B48 particles only in those with increased fasting TG levels, according to research published online Oct. 25 in Diabetes Care.

Gissette Reyes-Soffer, M.D., of the Columbia University Medical Center in New York City, and colleagues conducted a study involving a subset of 139 subjects (mean age, 61 years) from the Action to Control Cardiovascular Risk in Diabetes lipid study (ACCORD Lipid) to evaluate the effect of combination therapy with FENO-S compared with placebo plus simvastatin (PL-S) on PP lipid and lipoprotein levels. Primary measures included PP plasma TG, apoB48, and apoCIII, measured over 10 hours after an oral fat load.

The researchers found that the PP TG incremental area under the curve (IAUC) above fasting was 572 and 770 in the FENO-S and PL-S groups, respectively (P = 0.008). In the FENO-S versus the PL-S group, there was a significant reduction in PP apoB48 IAUC. On the day of the study, fasting TG levels correlated with PP TG IAUC for both FENO-S and PL-S groups. For PP TG IAUC, the fibrate effect was constant across the range of fasting TG levels, while for PP apoB48 IAUC, the reduction was only seen when fasting TG levels were increased.

"These results may have implications for interpretation of the overall ACCORD Lipid trial, which suggested benefit from FENO-S only in dyslipidemic individuals," the authors write.

One author disclosed financial ties to Abbott Laboratories and Merck Pharmaceuticals, both of which provided the study medications for the ACCORD Lipid trial.

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