Most of these 30 patients were male (73%), had diabetes (90%), were taking a fibrate
(93%), and/or were taking a statin (80%), with 23% of the whole cohort on maximum statin therapy (atorvastatin 40 or 80 mg daily, or rosuvastatin 40 mg daily).
However, the major challenge in the next few years remains to define how we should optimally use currently available therapies such as fibrates
or omega-3 fatty acids in patients with mild-to-moderate hypertriglyceridaemia and high cardiovascular risk.
To prevent HTGP recurrence, lifestyle modification including low-fat diet, alcohol cessation, and exercise as well as medications such as fibrates
, niacin, and n-3 fatty acids are the cornerstone of therapy.
In two studies (44,45) comparing the use of Omega 3 and fibrates
to reduce TG in HIV patients, the authors conclude that the reduction with fibrates
is bigger, but it occurs also with Omega3 (n-3 polynsaturated fatty acids-PUFA, polyunsaturated ethyl esters of n-3 fatty acids--PEE) showing improved tolerability, and this may potentially mean an effective and safe alternative to fibrates
may be considered as an alternative or adjunct to statins ...
Safety of Fibrates
and Omega 3 fatty acids was also discussed.
In analysis of clinical trial subgroups with both elevated TGs and low HDL, there appears to be additional benefit when niacin or fibrates
are added to statin therapy, but there is little evidence supporting routine use of these medications for treating TGs in your range.
Although fibrate-induced thrombocytopenia affects only a small fraction of patients taking medications of this class (3), this case report reinforces the fact that fibrates
may cause thrombocytopenia.
Therefore, other triglyceride-lowering agents may be needed to treat very high triglycerides; these agents include omega-3 fatty acids, niacins, and fibrates
, and cholesteryl ester transfer protein (CETP) inhibitors were all found to raise HDL cholesterol levels, but none of these was able to lower all-cause mortality rates, coronary heart disease-related mortality rates, or the risk of stroke compared with placebo.
Nearly all current cholesterol medicines -- fibrates
, niacin and top-selling statins -- are decades old.
decrease the amountof fats (lipids) in the blood.