Key result
Statin-fenofibrate therapy remains vital for CV risk reduction in hypertriglyceridemia lacking icosapent ethyl access.
Why the study?
The emergence of new evidence-based information prompted a review of indications for lipid-lowering therapy, particularly statin and fibrate combinations, in patients with hypertriglyceridemia.
Does combination therapy with a statin and fenofibrate provide a viable strategy for cardiovascular risk reduction in patients with hypertriglyceridemia?
Does combination therapy with a statin and fenofibrate provide a viable strategy for cardiovascular risk reduction in patients with hypertriglyceridemia?
Highlights the continued clinical importance of fenofibrate-statin combination therapy for managing hypertriglyceridemia in regions where first-line therapies like icosapent ethyl are unavailable.
May support statin-fenofibrate use where icosapent ethyl unavailable; leaves open need for contemporary randomized confirmation.
The article discusses the modern therapeutic approach to lowering blood triglyceride levels. The need to consider indications for the use of lipid-lowering therapy in patients with hypertriglyceridemia is caused by the emergence of new evidence-based information. The article describes how elevated blood TG levels are associated with the risk of developing cardiovascular (CV) complications, as well as pancreatitis. The mechanisms of TG metabolism that may regulate the relationship between elevated blood TG levels and the risk of developing CV complications are considered. The findings of large randomized clinical trials, including recent ones, which laid the foundation for the current clinical guidelines for the use of drugs to lower triglycerides levels, are discussed. Indications for fibrate therapy in patients with elevated blood TG levels in various clinical situations are considered. The article emphasizes that the icosapent ethyl ester drug is not currently available in the Russian Federation. According to the latest versions of international guidelines, it is considered a first-line drug to reduce the risk of developing CV complications in patients with an established diagnosis of CVD (i.e. for the purpose of secondary prevention). In this context, the significance of fenofibrate as a drug to lower blood triglyceride levels, specifically in secondary prevention of CV complications, can remain quite high in our country. The appearance of a rosuvastatin and fenofibrate combination drug on the pharmaceutical market of the Russian Federation will increase adherence to the therapy, if a fibrate is required to be added to statin therapy.
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S. R. Gilyarevskiy (2023) conducted a review in Hypertriglyceridemia. Combination therapy with statin and fenofibrate was evaluated. Combination therapy with statins and fenofibrate remains a vital strategy for cardiovascular risk reduction in patients with hypertriglyceridemia in regions where icosapent ethyl is unavailable.
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