The use of gemfibrozil in a patient with chronic myelogenous leukemia to successfully manage retinoid-induced hypertriglyceridemia

Abstract

Systemic retinoids are used in the management of chronic cutaneous conditions and life-threatening dermatoses. Unfortunately, drug-induced hypertriglyceridemia may necessitate either dose reduction or discontinuation of therapy. The purpose of this article is to describe the successful management of isotretinoin-induced hypertriglyceridemia with gemfibrozil in a leukemia patient. Sequential serum chemistries were performed prior to, during, and following treatment with a systemic retinoid and a lipid-regulating agent. A prompt and sustained normalization of fasting triglycerides occurred following the initiation of gemfibrozil in a patient with isotretinoin-induced hypertriglyceridemia. When retinoids are being used in the management of serious conditions, the initiation of therapy with gemfibrozil to reduce the elevated triglycerides may be appropriate in those patients with retinoid-induced hypertriglyceridemia.

A comparison of the effectiveness of soy protein isolate and fish oil for reducing the severity of retinoid-induced hypertriglyceridemia

“…For example, gemfibrozil (a fibric-acid derivative) has been used to lower elevated triglyceride concentrations caused by the use of 13cRA in the treatment of chronic myelogenous leukemia [17], and atorvastatin, a 3-hydroxy-3-methylglutaryl coenzyme A (HMGCoA) reductase inhibitor, has been used for the same purpose in patients receiving bexarotene for the treatment of T-cell lymphoma [4]. There are, however, side effects associated with the pharmacologic control of hyperlipidemia.…”

“…In this animal model, the severity of retinoid-induced hypertriglyceridemia can be reduced by replacing dietary casein with soy protein isolate (SPI) [14,15]. This finding raises the possibility that SPI may be useful in the control of retinoidinduced hypertriglyceridemia in human subjects and may offer an alternative to the use of lipid-lowering drugs for this purpose [4,17], thereby avoiding the side effects of these drugs [18]. Fish oil is effective at lowering serum triglyceride concentrations in patients receiving retinoids, including 13cRA [19 -21], although its effectiveness for this purpose in rats fed 13cRA has not been investigated.…”

Neuroprotective effects of gemfibrozil in neurological disorders: Focus on inflammation and molecular mechanisms

“…39 Gem is a medication utilized to manage hypertriglyceridemia caused by retinoids. 40 It is more effective than pravastatin, another lipid-lowering medication, in reducing triglycerides and increasing HDL cholesterol. 41 This drug is primarily used to treat individuals with Type IV and Type V hyperlipidemia who are at risk of developing cardiovascular ailments, coronary vascular issues, and other lipid-associated conditions.…”

“…Gem is a medication utilized to manage hypertriglyceridemia caused by retinoids 40 . It is more effective than pravastatin, another lipid‐lowering medication, in reducing triglycerides and increasing HDL cholesterol 41 .…”

The Endocrine Effects of Nonhormonal Antineoplastic Therapy

“…Their effects on lipid metabolism are well characterized (298 -307), although the mechanism of development of lipid abnormality is less clear. Hyperlipidemia associated with retinoid therapy has been treated with gemfibrozil (310,311) or fish oil (312,313). Retinoid-induced hypertriglyceridemia has been reported to cause cerebrovascular infarction (308) and pancreatitis (304,309).…”