Fibrates in 2018: story goes on

Authors: Richard Češka;  Michal Vrablík;  Tomáš Štulc
Authors‘ workplace: Centrum preventivní kardiologie, III. interní klinika 1. LF UK a VFN v Praze
Published in: AtheroRev 2018; 3(3): 161-168
Category: Reviews


At present, pharmacological intervention for dyslipidemia (DLP) is primarily aimed at the effect of LDL-C statins. In monotherapy then possibly in combination with ezetimibe (or, most modernly, with PCSK9-inhibitors). For atherogenic dyslipidemia, in particular in the context of type 2 diabetes (DM2T) or possibly the metabolic syndrome, statin-fibrate combination can be used. Atherogenic dyslipidemia refers to elevated levels of triglycerides along with lower levels of HDL-cholesterol (and change in the quality of LDL particles in favour of the “small dense” ones). Epidemiological development, new findings concerning significance of atherogenic dyslipidemia and possibilities of its influencing have led to the formulation of consensus by European experts on this issue. Atherogenic dyslipidemia regularly accompanies conditions associated with insulin resistance. It is totally irrelevant whether we use the terms metabolic syndrome, diabetic dyslipidemia or cardiometabolic risk. The treatment is based on rigorous adjustment of diet and regimen. As mentioned above, pharmacotherapy is based on statins. Fenofibrate combination should be considered for patients with persistent hypertriglyceridemia and unsatisfactory management of non-HDL-C. This brings further decrease in the risk for macrovascular as well as microvascular complications in such condition. Positive effects, in particular due to fenofibrate, can be observed mainly in patients with diabetes. The aim of this report is to provide an up-to-date overview of possibilities of utilizing fibrates with regard to the conditions of actual Czech practice which basically keeps using fenofibrate only even in the early 21st century.

Key words:

atherogenic dyslipidemia, diabetic dyslipidemia, fenofibrate , non-HDL-cholesterol, statins

Received: 10. 9. 2018

Accepted: 1. 10. 2018

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Angiology Diabetology Internal medicine Cardiology General practitioner for adults
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