Alternate Day Statin and Fibrate Given Alone or in Combination for Postprandial Dyslipidemia in Patients with Type 2 Diabetes Mellitus: A Preliminary Report
10.35460/2546-1621.2017-0032
- Author:
Sheila Farisha K MANGELEN
1
;
Erick S MENDOZA
2
;
Leilani B MERCADO-ASIS
3
Author Information
1. Principal author, Fellow-in-Training, Section of Endocrinology, Diabetes and Metabolism of the Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines
2. Co-author and Consultant, Section of Endocrinology, Diabetes and Metabolism of the Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines
3. Senior Author and Consultant, Section of Endocrinology, Diabetes and Metabolism of the Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines
- Publication Type:Journal Article
- Keywords:
fi brate and postprandial dyslipidemia
- MeSH:
Hydroxymethylglutaryl-CoA Reductase Inhibitors
- From:
Journal of Medicine University of Santo Tomas
2018;2(1):214-219
- CountryPhilippines
- Language:English
-
Abstract:
Introduction:Postprandial lipemia represent an
important risk factor for lifetime development of cardiovascular disease in patients with type 2 diabetes mellitus. Daily administration alone or combined
statin and fi brate therapy has been shown to be an
effective therapeutic approach but brings about serious logistics problem in our local setting. To address
this concern, we report this observation where alternate day statin and fi brate treatment given alone
or in combination in type 2 diabetes mellitus and
similar effectiveness in lowering postprandial dyslipidemia has been obtained.
Methodology:This is a retrospective case study in
an endocrine clinic involving 53 patients seen from
April 2014 to October 2015. The patients were
on statin and fi brate combination (atorvastatin 20-
40mg and gemfi brozil 300-600 mg or fenofi brate
145-160mg), statin alone (atorvastatin 20-40mg)
and fi brate alone (gemfi brozil 300-600mg/fenofi -
brate 145-160mg) given on alternate days. Percent
reductions of cholesterol, triglycerides, LDL for combined statin and fi brate; cholesterol and LDL for
atorvastatin alone; and triglyceride for fi brate alone
were determined.
Results:In this preliminary report, 26 patients have
available data. Follow-up period range was 4 to 48
weeks (mean 22.76+ 11.8 weeks). Alternate statin
and fi brate (gemfi brozil) treatment yielded percent
reductions from baseline as follows: cholesterol 7%,
triglycerides 15%, and LDL 37% (P values= 0.02,
0.10 and 0.019, respectively). On the other hand,
alternate statin and fi brate (fenofi brate) yielded percent reduction from baseline as follows: cholesterol
41% and LDL 20.4% (P=0.15 and 0.13, respectively). The population is small, the decrease did not yield signifi cant difference from baseline, however there is a tendency for triglyceride to decrease
(P=0.09) with the combined statin and fenofi brate.
With statin alone the percent reduction from baselinewere as follows: cholesterol 39% and LDL 62%
(P= 0.29 and 0.11, respectively). No percent reduction of triglyceride is seen with fi brate given on alternate day with P= 0.19 The monthly cost reduction
with combined alternate statin and fi brate treatment
is at 34-48% while alternate day administration of
the statin reduced cost by 60%.
Conclusion:This study showed lowering of postprandial total cholesterol, triglyceride and LDL with
alternate statin and fi brate treatment, and total cholesterol and LDL with alternate day statin. The cost
of treatment was also signifi cantly lowered with the
alternate regimen. However, a follow through study
with adequate sample size is recommended to support these observations.
- Full text:JMUST 012.pdf
