Monotherapy with either fibrates or statins suggested a significantly greater effect of fibrates in lowering plasma Fib concentrations .
According to these findings , mechanisms associated with fibrinogen metabolism might be responsible for the distinct effects of statins and fibrates in reducing cardiovascular endpoints
BACKGROUND Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen ( Fib ) concentrations , but the evidence is not definitive .
Therefore , the aim of this meta- analysis of head-to-head r and omized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations .
Multicenter comparison of micronized fenofibrate and simvastatin in patients with primary type IIA or IIB hyperlipoproteinemia.
In 12 weeks of active treatment , we compared the efficacy and safety of a new ( micronized ) formulation of fenofibrate ( F ) ( 200 mg/day ) with that of simvastatin ( S ) ( 20 mg/day ) , an inhibitor of hydroxy-methyl-glutaryl coenzyme A (HMG-CoA)-reductase . Men and women with primary hyperlipoproteinemia ( HLP ) with low-density lipoprotein ( LDL ) cholesterol level 180 - 300 mg/dl and triglyceride level < 500 mg/dl had dietary treatment for 8 weeks , and 133 ( 2 of 3 type IIa , 1 of 3 type IIb HLP ) were r and omized . The decrease in total cholesterol differed between type IIa patients ( F - 17.9 vs. S - 25.8 % ) , the decrease in triglyceride levels between the type II b groups ( F - 52.8 vs. S - 14 % ) , whereas the degree of decrease in LDL cholesterol ( F - 20.9 vs. S - 34.9 % ) differed among all patients . Despite the difference in LDL cholesterol decrease , no difference was noted in total apolipoprotein ( apo ) B lowering ( F - 20.8 and S - 26.5 % ) . Increases in high-density lipoprotein ( HDL ) cholesterol ( F + 18.5 vs. S + 15 % ) differed specifically in type IIb patients ( F + 33.6 vs. S + 11.4 % ) , accompanied by a more pronounced increase in apo AI with fenofibrate ( F + 10.5 % vs. S no change ) . Improvement in the ratios of total cholesterol/HDL cholesterol and apo AI/apo B occurred similarly with both drugs . Only fenofibrate , not simvastatin , decreased both fibrinogen ( -10.3 vs. + 3.6 % ) and uric acid ( -25 % vs. no change ) in type IIa and type IIb patients . Safety parameters reflected drug-specific known side effects , underscoring the safety of both drugs in addition to their efficacy in lipid lowering . Besides its advantages in type IIb hyperlipidemia , micronized fenofibrate proved a potent drug in decreasing total and LDL cholesterol and in very effectively decreasing apo B-containing lipoproteins , which is a recommendation for its use in primary hypercholesterolemia
Monotherapy with either fibrates or statins suggested a significantly greater effect of fibrates in lowering plasma Fib concentrations .
According to these findings , mechanisms associated with fibrinogen metabolism might be responsible for the distinct effects of statins and fibrates in reducing cardiovascular endpoints
BACKGROUND Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen ( Fib ) concentrations , but the evidence is not definitive .
Therefore , the aim of this meta- analysis of head-to-head r and omized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations .