Reference : Place des fibrates dans le traitement de patients avec une dyslipidemie atherogene.
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
Human health sciences : Pharmacy, pharmacology & toxicology
Place des fibrates dans le traitement de patients avec une dyslipidemie atherogene.
[en] Place of fibrates for the treatment of patients with atherogenic dyslipidemia
Ducobu, J. [> > > >]
Scheen, André mailto [Université de Liège - ULiège > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
Legat, P. [> > > >]
De Backer, G. [> > > >]
Van Gaal, L. [> > > >]
Velkeniers, B. [> > > >]
Kartounian, J. [> > > >]
Maes, Murielle [> > > >]
Hermans, M [Katholieke Universiteit Brussel - KUB > E n d o c r i n o l o g i e e t N u t r i t i o n , > > >]
Revue Médicale de Liège
Hopital de Baviere
Yes (verified by ORBi)
[en] Atherogenic dyslipidemia ; Triglycerides ; Statin ; Metabolic syndrome ; Fibrate ; Diabetes ; Combined therapy
[en] The demography of dyslipidemia has changed towards a more complex atherogenic dyslipidemia involving increased levels of LDL cholesterol, in particular highly atherogenic small dense particles, hypertriglyceridemia and low HDL cholesterol, together with increased levels of markers of inflammation, thrombogenesis and endothelial dysfunction. Statins were shown to significantly lower cardiovascular morbidity and mortality, but treated patients are still left with a high residual risk, in particular for those with metabolic syndrome, type 2 diabetes, or low HDL cholesterol levels. Fibrates have been shown to reduce plasma triglycerides and increase HDL cholesterol, while improving inflammation, thrombogenesis and endothelial dysfunction. Clinical trials with fibrates have demonstrated their potential to reduce cardiovascular morbidity and mortality too, often through other mechanisms than those of statins. Combination trials of statins with fibrates have shown a more complete improvement of lipid profile and risk markers than each class separately. In contrast with gemfibrozil, fenofibrate does not interact significantly with the pharmacokinetics of statins, and its combination with statins has been shown to have a low risk of muscular side-effects or liver toxicity. The ACCORD outcome trial is exploring possible benefits of the combination of fenofibrate with statins on morbidity and mortality of patients with type 2 diabetes.

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