Korean J Med.  2003 Dec;65(6):682-689.

Efficacy and safety of the combination therapy of HMG CoA reductase inhibitor and fibrate in combined dyslipidemia

• Kim SM
• Lee KE
• Lee SH
• Jung KS
• Kim SJ
• Lee KJ
• Kim SW
• Kim TH
• Ko HS
• Kim CJ
• Ryu WS

Abstract

BACKGROUND: The combination therapy of HMG CoA reductase inhibitor (statin) and fibrate is more effective than each ones in managing combined dyslipidemia. However, this therapy tends to be avoided due to potential risk of rhabdomyolysis. The aim of the study was to reevaluate the efficacy and safety of combination therapy.
METHODS
A total 61 patients were divided into three groups according to lipid levels and medications; statin+fibrate group (n=10), statin group (n=31) and fibrate group (n=18). Patients with active hepatitis or renal dysfunction who were at high risk for complications were excluded. Lipid profiles were measured before and 2 months after medications.
RESULTS
Combination therapy markedly decreased total cholesterol, low density lipoproteincholesterol (LDL-C) and triglyceride concentrations (p=0.008, p=0.028 and p=0.018 respectively), and increased high density lipoprotein-cholesterol (HDL-C)(p=0.028). The effects of this therapy on HDL-C and triglyceride were more potent than those of statin. Combination therapy was more effective in lowering LDL-C than fibrate. Serious complications such as myopathy and marked elevation of transaminase level were not observed in all groups. In statin+fibrate group, transaminase level was elevated slightly above the normal range in two cases. Creatine kinase level showed the trend to increase with borderline significance. However the levels were within normal range in 9 cases and elevated twofold in one patient.
CONCLUSION
Combination therapy of statin and fibrate was effective in combined dyslipidemia and well tolerated in patients without high risk for the complications although the number of cases was small to get a conclusion.

Keyword

Hydroxymethylglutaryl-CoA Reductase Inhibitors; Antilipemic Agents; Lipid; Lipoprotein

MeSH Terms

Cholesterol
Creatine Kinase
Dyslipidemias*
Hepatitis
Humans
Hydroxymethylglutaryl CoA Reductases*
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypolipidemic Agents
Lipoproteins
Muscular Diseases
Reference Values
Rhabdomyolysis
Triglycerides
Cholesterol
Creatine Kinase
Hydroxymethylglutaryl CoA Reductases
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypolipidemic Agents
Lipoproteins