Effect of Ciprofibrate on C-Reactive Protein and Fibrinogen Levels

Abstract

Statins can lower the circulating levels of C reactive protein (CRP). This effect may be relevant because CRP is a predictor of vascular risk. In contrast, the evidence that fibrates lower CRP levels is very limited. The effect of treatment with ciprofibrate (100 mg once daily) was investigated for 8 weeks in 30 patients with primary dyslipidemia. There was a significant (p < 0.01) decrease in median (range) CRP levels by 36.8% from 1.9 mg/L (1.0-6.0 mg/L) to 1.2 mg/L (1.0-5.5 mg/L). Plasma fibrinogen levels were also significantly (p = 0.05) reduced. There was no correlation between the fall in CRP levels and the changes in lipid or fibrinogen levels. These findings support the concept that fibrates, like the statins, lower serum CRP levels. However, fibrates have a different mode of action. Fibrates (with the exception of gemfibrozil) also consistently lower plasma fibrinogen levels. In contrast, the effect of statins on the circulating levels of this coagulation factor remains to be defined. These differences may help in defining the mechanisms responsible for drug-induced changes in the circulating levels of CRP and fibrinogen. A favorable effect on CRP and fibrinogen levels may increase the clinical efficacy of statins and fibrates.

Global Suppression of IL-6-induced Acute Phase Response Gene Expression after Chronic in Vivo Treatment with the Peroxisome Proliferator-activated Receptor-α Activator Fenofibrate

“…bezafibrate (18) and ciprofibrate (38). In this study, we demonstrate that treatment with fenofibrate has a much broader effect on plasma levels of APR proteins in humans and causes down-regulation of SAA, ␣2-macroglobulin, and plasminogen.…”

Evaluation of C-Reactive Protein Measurement for Assessing the Risk and Prognosis in Ischemic Stroke

“…173 Although the data for other lipid-lowering agents are less robust, fibrates appear to act in a similar manner, 174,175 and niacin and gemfibrozil have also been reported to reduce CRP concentration. 176 Whether lowering CRP concentrations represents a useful pharmacological goal in itself is unclear. Evidence from animal studies in myocardial infarction and ischemic stroke has shown that CRP exacerbates ischemic injury in the acute phase, through complement binding, 42,[177][178][179][180] but the extent to which this mechanism is pathophysiologically relevant in the chronic inflammatory response to atherosclerosis is uncertain.…”

C-reactive protein (CRP): more than just an innocent bystander?

“…Following lower extremity bypass operations, elevated CRP levels are associated with an increased risk of graft occlusion and postoperative e v e n t s 2 3-2 5 . I n p a t i e n t s u n d e r g o i n g c a r o t i d 40 , statins (atorvastatin [41][42][43][44] , rosuvastatin 35,41,42 , fluvastatin 45 and pravastatin 46 ), fenofibrate 43,44,47 and ciprofibrate 48,49 . The mechanisms by which these drugs lower CRP levels are more extensively reviewed elsewhere 50 .…”