Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .
Combined bezafibrate and simvastatin treatment for mixed hyperlipidaemia.
The safety and efficacy of combined bezafibrate-simvastatin therapy was evaluated in 49 patients with diet-resistant mixed hyperlipidaemia ( type IIb ) . After a two-month placebo phase , patients were r and omized to receive either Bezafibrate Slow Release ( SR ) 400 mg mane or simvastatin 20 mg nocte followed by three months combination therapy . Total cholesterol , triglycerides and high-density lipoprotein ( HDL ) cholesterol were measured at monthly intervals . Apolipoproteins ( apo ) A1 and B , lipoprotein ( a ) [ Lp(a ) ] and fibrinogen were measured before and after each treatment . Simvastatin was more effective than Bezafibrate SR in reducing total cholesterol ( 2.0 vs. 1.1 mmol/l , p = 0.003 ) and lowering LDL cholesterol ( 1.7 vs. 0.4 mmol/l , p = 0.0001 ) whereas Bezafibrate SR was more effective in reducing triglycerides ( by 41 % vs. 17 % , p = 0.001 ) and fibrinogen ( by 23 % vs. 3 % , p = 0.004 ) . Compared with simvastatin monotherapy , combined drug therapy induced further reductions in triglycerides ( by 26 % , p = 0.0003 ) and apoB ( by 11 mg/dl , p = 0.03 ) and an increase in apoA1 ( by 21 mg/dl , p = 0.0008 ) . Symptomatic and biochemical adverse events did not occur more frequently on combined drug therapy than on monotherapy . The combination of bezafibrate and simvastatin was more effective in controlling mixed hyperlipidaemia than either drug alone and did not provoke more adverse events
Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .