Attainment of goal/desirable lipid levels in patients with mixed dyslipidemia after 12 weeks of treatment with fenofibric acid and rosuvastatin combination therapy: A pooled analysis of controlled studies

作者：Roth Eli M^*; Rosenson Robert S; Jones Peter H; Davidson Michael H; Kelly Maureen T; Setze Carolyn M; Lele Aditya; Thakker Kamlesh

来源：Journal of Clinical Lipidology, 2012, 6(6): 534-544.

DOI：10.1016/j.jacl.2012.02.002

• Fenofibric acid
• Rosuvastatin
• Combination therapy
• Mixed dyslipidemia
• Lipoproteins

BACKGROUND: Goal/desirable lipid levels are underachieved in patients with mixed dyslipidemia. These patients may have substantial residual risk of cardiovascular disease even while receiving optimal LDL-C-lowering therapy and may require additional therapy to improve multiple lipid/lipoprotein levels. %26lt;br%26gt;OBJECTIVE: To evaluate attainment of goal/desirable levels of lipids/lipoproteins after 12-week treatment with combination rosuvastatin + fenofibric acid versus rosuvastatin monotherapy. %26lt;br%26gt;METHODS: This was a post hoc analysis of patients with mixed dyslipidemia who enrolled in one of two randomized controlled trials, and were treated (N = 2066) with rosuvastatin (5, 10, or 20 mg), fenofibric acid 135 mg, or rosuvastatin + fenofibric acid for 12 weeks. Data were pooled across doses of rosuvastatin as monotherapy and combination therapy. %26lt;br%26gt;RESULTS: Compared with rosuvastatin monotherapy, combination therapy had comparable effects in achieving risk-stratified LDL-C goals; however, measures of total atherogenic burden were improved because significantly greater percentages of patients attained non-HDL-C goal in high- (62.9% vs 50.4%, P = .006) and moderate-risk groups (87.6% vs 80.4%, P = .016) and apolipoprotein B (ApoB) %26lt;90 mg/dL in high-risk group (59.8% vs 43.8%, P %26lt; .001). In the overall population, more patients treated with the combination therapy achieved desirable levels of HDL-C %26gt;40/50 mg/dL in men/women (P %26lt; .001), triglycerides %26lt;150 mg/dL (P %26lt; .001), and ApoB %26lt;90 mg/dL (P %26lt; .001), compared with rosuvastatin monotherapy. Furthermore, combination therapy resulted in significantly greater percentages of patients achieving simultaneous specified levels of LDL-C + non-HDL-C (P %26lt; .015); LDL-C + HDL-C + TG (P %26lt; .001); and LDL-C + HDL-C + triglycerides + non-HDL-C + ApoB (P %26lt; .001), compared with rosuvastatin monotherapy. %26lt;br%26gt;CONCLUSION: Rosuvastatin + fenofibric acid may be more efficacious than rosuvastatin alone in patients with mixed dyslipidemia.

• 出版日期2012-12