Combination therapy in the management of mixed dyslipidaemia

Cannon, Christopher P.

doi:10.1111/j.1365-2796.2008.01933.x

Cited by 27 publications

(19 citation statements)

References 93 publications

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“…Statins potently inhibit the 3-hydroxymethyl-glutaryl-coenzyme A (HMG-CoA) reductase, the rate-limiting enzyme for the synthesis of mevalonate and therefore cholesterol [1]. Fibrates by acting on the peroxisome proliferator-activated receptor (PPAR)-α, lower serum triglyceride levels and increase high-density lipoprotein (HDL)-cholesterol [2].…”

Section: Introductionmentioning

confidence: 99%

Statin or fibrate chronic treatment modifies the proteomic profile of rat skeletal muscle

Camerino

Pellegrino

Brocca

et al. 2011

Biochemical Pharmacology

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Statins and fibrates can cause myopathy. To further understand the causes of the damage we performed a proteome analysis in fast-twitch skeletal muscle of rats chronically treated with different hypolipidemic drugs. The proteomic maps were obtained from extensor digitorum longus (EDL) muscles of rats treated for 2-months with 10mg/kg atorvastatin, 20mg/kg fluvastatin, 60mg/kg fenofibrate and control rats. The proteins differentially expressed were identified by mass spectrometry and further analysed by immunoblot analysis. We found a significant modification in 40 out of 417 total spots analysed in atorvastatin treated rats, 15 out of 436 total spots in fluvastatin treated rats and 21 out of 439 total spots in fenofibrate treated rats in comparison to controls. All treatments induced a general tendency to a down-regulation of protein expression; in particular, atorvastatin affected the protein pattern more extensively with respect to the other treatments.Energy production systems, both oxidative and glycolytic enzymes and creatine kinase, were downregulated following atorvastatin administration, whereas fenofibrate determined mostly alterations in glycolytic enzymes and creatine kinase, oxidative enzymes being relatively spared. Additionally, all treatments resulted in some modifications of proteins involved in cellular defenses against oxidative stress, such as heat shock proteins, and of myofibrillar proteins. These results were confirmed by immunoblot analysis. In conclusions, the proteomic analysis showed that either statin or fibrate administration can modify the expression of proteins essential for skeletal muscle function suggesting potential mechanisms for statin myopathy.

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Section: Introductionmentioning

confidence: 99%

Statin or fibrate chronic treatment modifies the proteomic profile of rat skeletal muscle

Camerino

Pellegrino

Brocca

et al. 2011

Biochemical Pharmacology

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“…those with high triglyceride levels, low high-density lipoprotein cholesterol [HDL-C] levels and small dense LDL particles), LDL-C levels may underestimate the cardiovascular risk. [2] Therefore, the US guidelines [1] recommend lowering both LDL-C and non-HDL-C in patients with hypertriglyceridemia.…”

Section: What Is the Rationale For Developing The Fixed-dose Combinatmentioning

confidence: 99%

“…[1,2] At pharmacologic doses, niacin displays wide-ranging lipid-modifying activity, reducing levels of all atherogenic lipid and lipoprotein subclasses, including total cholesterol, LDL-C, non-HDL-C, triglycerides, apolipoprotein B, and lipoprotein(a), and also significantly increasing levels of HDL-C and apolipoprotein A. [3,4] As niacin extended release (ER) and simvastatin have complementary mechanisms of action, the combination of these agents in a fixed-dose formulation (Simcor Ò ) may lead to the attainment of lipid regulation goals when monotherapy with simvastatin or niacin ER is considered inadequate (table I).…”

Section: What Is the Rationale For Developing The Fixed-dose Combinatmentioning

confidence: 99%

Niacin Extended Release (ER)/Simvastatin (Simcor®)

Lyseng‐Williamson

2010

Drugs R D

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“…Adherence might also be higher with the combination therapy of a FF or DS and a statin compared with a multidrug therapy, as patients might be more willing to slightly modify their diet by replacing normal food items with comparable FF, compared with taking another drug; patients' perception of overmedication has been found to correlate with selfreport of decreased adherence (10) . Other advantages of the combination therapy with FF or DS compared with multidrug therapy are the lower drug costs and the reduced risk for interactions and serious side effects (11) .…”

mentioning

confidence: 99%

Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

et al. 2010

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Functional foods and dietary supplements might have a role in supporting drug therapy. These products may (1) have an additive effect to the effect that a drug has in reducing risk factors associated with certain conditions, (2) contribute to improve risk factors associated with the condition, other than the risk factor that the drug is dealing with, or (3) reduce drug-associated side effects, for example, by restoring depleted compounds or by reducing the necessary dose of the drug. Possible advantages compared with a multidrug therapy are lower drug costs, fewer side effects and increased adherence. In the present review we have focused on the support of statin therapy using functional foods or dietary supplements containing plant sterols and/or stanols, soluble dietary fibre, n-3 PUFA or coenzyme Q 10 . We conclude that there is substantial evidence that adding plant sterols and/or stanols to statin therapy further reduces total and LDL-cholesterol by roughly 6 and 10 %, respectively. Adding n-3 PUFA to statin therapy leads to a significant reduction in plasma TAG of at least 15 %. Data are insufficient and not conclusive to recommend the use of soluble fibre or coenzyme Q 10 in patients on statin therapy and more randomised controlled trials towards these combinations are warranted. Aside from the possible beneficial effects from functional foods or dietary supplements on drug therapy, it is important to examine possible (negative) effects from the combination in the long term, for example, in post-marketing surveillance studies. Moreover, it is important to monitor whether the functional foods and dietary supplements are taken in the recommended amounts to induce significant effects. Combination therapy: Dyslipidaemia: Statins: Functional foodsThe world market for functional foods (FF) and dietary supplements (DS) is expanding rapidly. In 2010 FF are expected to represent 5 % of the total global food market (1) and the market for DS is estimated at more than $60 billion worldwide (2) . In general, the target population of FF or DS is healthy individuals with slightly elevated risk factors or some physical discomfort. However, due to the fast growing market of FF or DS and the accompanying strong advertising and marketing, also patients on medication may be stimulated to use FF or DS. This may have several consequences for the quality of drug treatment as stated by de Jong et al. with the example of the combined intake of plant sterols and/or stanols and statins (3) . Whereas they addressed the additive effect of plant sterols and/or stanols on reducing LDL-cholesterol values in patients on statin treatment, their main focus was the possible negative aspects of the combination, such as unfavourable effects on patient adherence with drug treatment and increasing the potential for food-drug interactions.In the present review we will focus on the possible beneficial effects that FF or DS may have on drug therapy. Because of the large number of subjects treated suboptimally with statins (hydroxymethylglutaryl Co...

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Combination therapy in the management of mixed dyslipidaemia

Abstract: Abstract. Cannon CP (Brigham and Women

Cited by 27 publications

References 93 publications

Statin or fibrate chronic treatment modifies the proteomic profile of rat skeletal muscle

Statin or fibrate chronic treatment modifies the proteomic profile of rat skeletal muscle

Niacin Extended Release (ER)/Simvastatin (Simcor®)

Support of drug therapy using functional foods and dietary supplements: focus on statin therapy

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