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01.01.2007 | Adis Drug Evaluation

Fenofibrate

A Review of its Use in Primary Dyslipidaemia, the Metabolic Syndrome and Type 2 Diabetes Mellitus

verfasst von: Gillian M. Keating, Katherine F. Croom

Erschienen in: Drugs | Ausgabe 1/2007

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Abstract

Fenofibrate is a fibric acid derivative indicated for use in the treatment of primary hypercholesterolaemia, mixed dyslipidaemia and hypertriglyceridaemia in adults who have not responded to nonpharmacological measures. Its lipid-modifying effects are mediated by activation of peroxisome proliferator-activated receptor-α. Fenofibrate also has nonlipid (i.e. pleiotropic) effects (e.g. it reduces fibrinogen, C-reactive protein and uric acid levels and improves flow-mediated dilatation).

Fenofibrate improves lipid levels (in particular triglyceride [TG] and high-density lipoprotein-cholesterol [HDL-C] levels) in patients with primary dyslipidaemia. Its lipid-lowering profile means that fenofibrate is particularly well suited for use in atherogenic dyslipidaemia (characterised by high TG levels, low HDL-C levels and small, dense low-density lipoprotein [LDL] particles), which is commonly seen in patients with the metabolic syndrome and type 2 diabetes mellitus. Indeed, fenofibrate improves the components of atherogenic dyslipidaemia in patients with these conditions, including a shift from small, dense LDL particles to larger, more buoyant LDL particles. Greater improvements in lipid levels are seen when fenofibrate is administered in combination with an HMG-CoA reductase inhibitor (statin) or in combination with ezetimibe, compared with monotherapy with these agents. In the DAIS study, fenofibrate significantly slowed the angiographic progression of focal coronary atherosclerosis in patients with type 2 diabetes. In terms of clinical outcomes, although no significant reduction in the risk of coronary events was seen with fenofibrate in the FIELD trial in patients with type 2 diabetes, treatment was associated with a significantly reduced risk of total cardiovascular disease (CVD) events, primarily through the prevention of non-fatal myocardial infarction and coronary revascularisation. Subgroup analyses revealed significant reductions in total CVD events and coronary heart disease events in patients with no previous CVD, suggesting a potential role for primary prevention with fenofibrate in patients with early type 2 diabetes. Improvements were also seen in microvascular outcomes with fenofibrate in the FIELD trial. Fenofibrate is generally well tolerated, both as monotherapy and when administered in combination with a statin. Combination therapy with fenofibrate plus a statin appears to be associated with a low risk of rhabdomyolysis; no cases of rhabdomyolysis were reported in patients receiving such therapy in the FIELD trial. Thus, fenofibrate is a valuable lipid-lowering agent, particularly in patients with atherogenic dyslipidaemia.

Trade names for the various fenofibrate formulations include Catalip®, Fulcro®, Lipanthyl®, Lipantil®, Lipidil®, Lipcor®, Secalip®, Supralip® and Tricor®. The use of trade names is for product identification purposes only and does not imply endorsement.

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Titel: Fenofibrate
A Review of its Use in Primary Dyslipidaemia, the Metabolic Syndrome and Type 2 Diabetes Mellitus
verfasst von: Gillian M. Keating
Katherine F. Croom
Publikationsdatum: 01.01.2007
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 1/2007
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200767010-00013

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Fenofibrate

A Review of its Use in Primary Dyslipidaemia, the Metabolic Syndrome and Type 2 Diabetes Mellitus

Abstract

Live-Webinar "Urologie und Sexualmedizin in der Praxis"

Springer Medizin

Abstract

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