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Fenofibric Acid

In Combination Therapy in the Treatment of Mixed Dyslipidemia

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Abstract

▴ Fenofibric acid activates peroxisome proliferator-activated receptor α to modify fatty acid and lipid metabolism. Fenofibric acid is the first member of the fibric acid derivatives (fibrates) class approved for use as combination therapy with HMG-CoA reductase inhibitors (statins).

▴ In three randomized, double-blind, multicenter, phase III trials in adult patients with mixed dyslipidemia, up to 12 weeks’ treatment with once-daily fenofibric acid 135 mg plus a low- or moderate-dose statin (atorvastatin 20 or 40 mg, rosuvastatin 10 or 20 mg, or simvastatin 20 or 40 mg) improved high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels to a significantly greater extent than statin monotherapy, and improved low-density lipoprotein cholesterol (LDL-C) levels to a significantly greater extent than fenofibric acid monotherapy.

▴ In a 52-week, open-label, multicenter, extension study, HDL-C, TG, and LDL-C levels continued to improve, or were maintained, during combination therapy with once-daily fenofibric acid 135 mg plus a moderate-dose statin (atorvastatin 40 mg, rosuvastatin 20 mg, or simvastatin 40 mg).

▴ Once-daily fenofibric acid 135 mg plus a statin was generally as well tolerated as monotherapy with fenofibric acid 135 mg/day or the corresponding statin dosage in the three phase III trials in patients with mixed dyslipidemia. The incidence of adverse events was similar between the combination therapy group and both monotherapy groups.

▴ In the extension trial, once-daily fenofibric acid 135 mg plus a moderate-dose statin (atorvastatin 40 mg, rosuvastatin 20 mg, or simvastatin 40 mg) for up to 52 weeks was generally well tolerated.

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Acknowledgments and Disclosures

The manuscript was reviewed by: P.R. Devchand, Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA; R. Guthrie Department of Emergency Medicine, Ohio State University, Columbus, Ohio, USA; S.J. Nicholls, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.

The preparation of this review was not supported by any external funding. During the peer review process, the manufacturer of the agent under review was offered an opportunity to comment on this article. Changes resulting from comments received were made on the basis of scientific and editorial merit.

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Correspondence to Lily P. H. Yang.

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Yang, L.P.H., Keating, G.M. Fenofibric Acid. Am J Cardiovasc Drugs 9, 401–409 (2009). https://doi.org/10.2165/11203920-000000000-00000

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