Comparison of the efficacy of simvastatin and standard fibrate therapy in the treatment of primary hypercholesterolemia and combined hyperlipidemia.
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Bruckert E, De Gennes JL, Malbecq W, Baigts F
Comparison of the efficacy of simvastatin and standard fibrate therapy in the treatment of primary hypercholesterolemia and combined hyperlipidemia.
Clin Cardiol. 1995 Nov;18(11):621-9.
- PubMed ID
- 8590530 [ View in PubMed]
- Abstract
Five multicenter, randomized, double-blind, placebo-controlled studies were conducted in France to compare the efficacy and safety of once-daily simvastatin treatment (10-40 mg/day) with conventional therapy with gemfibrozil 900 mg/day, ciprofibrate 100 mg/day, bezafibrate 400 mg/day, and fenofibrate 300 or 400 mg/day in a total of 800 patients with hypercholesterolemia. Simvastatin was associated with statistically significantly greater (p < or = 0.01) mean percent reductions in plasma low-density lipoprotein (LDL) cholesterol compared with each of the five fibrate regimens, even when administered at its recommended starting dose of 10 mg/day. Furthermore, approximately 90% of patients treated once daily with simvastatin experienced an at least 20% decrease in plasma LDL cholesterol compared with only 36 to 68% of patients treated with the individual fibrate agents (p < or = 0.05). The effectiveness of simvastatin in reducing LDL cholesterol did not differ as a function of the baseline plasma concentrations of total cholesterol or triglycerides. In contrast, the effectiveness of fibrate therapy in lowering plasma LDL cholesterol levels was significantly diminished (p < or = 0.05) among patients with triglyceride concentrations > 1.7 mmol/l. Plasma high-density lipoprotein (HDL) cholesterol levels were increased by approximately 10% after treatment with simvastatin or the fibrates. Although fibrate therapy was more effective overall in lowering plasma triglyceride levels, the effectiveness of simvastatin in reducing plasma triglyceride levels was generally 2- to 4-fold greater in patients with hypercholesterolemia associated with triglyceride levels > or = 2.3 mmol/l than in those with hypercholesterolemia associated with triglyceride levels < 2.3 mmol/l. The results of these studies confirm the superiority of simvastatin to standard fibrate therapy in reducing plasma levels of total and LDL cholesterol. They further indicate that once-daily treatment with simvastatin is effective in patients with isolated hypercholesterolemia or hypercholesterolemia associated with elevated triglyceride levels.
DrugBank Data that Cites this Article
- Pharmaco-metabolomics
Drug Drug Groups Metabolite Change Description Ciprofibrate Approved Investigational LDL cholesterol decreased Ciprofibrate decreases the level of LDL cholesterol in the blood Ciprofibrate Approved Investigational Total cholesterol decreased Ciprofibrate decreases the level of Total cholesterol in the blood Fenofibrate Approved Total cholesterol decreased Fenofibrate decreases the level of Total cholesterol in the blood Gemfibrozil Approved Total cholesterol decreased Gemfibrozil decreases the level of Total cholesterol in the blood Gemfibrozil Approved LDL cholesterol decreased Gemfibrozil decreases the level of LDL cholesterol in the blood Ciprofibrate Approved Investigational HDL cholesterol increased Ciprofibrate increases the level of HDL cholesterol in the blood Bezafibrate Approved Investigational LDL cholesterol decreased Bezafibrate decreases the level of LDL cholesterol in the blood Simvastatin Approved Total cholesterol decreased Simvastatin decreases the level of Total cholesterol in the blood Gemfibrozil Approved HDL cholesterol increased Gemfibrozil increases the level of HDL cholesterol in the blood Simvastatin Approved HDL cholesterol increased Simvastatin increases the level of HDL cholesterol in the blood Fenofibrate Approved HDL cholesterol increased Fenofibrate increases the level of HDL cholesterol in the blood Fenofibrate Approved LDL cholesterol decreased Fenofibrate decreases the level of LDL cholesterol in the blood Ciprofibrate Approved Investigational Triglycerides decreased Ciprofibrate decreases the level of Triglycerides in the blood Fenofibrate Approved Triglycerides decreased Fenofibrate decreases the level of Triglycerides in the blood Simvastatin Approved Triglycerides decreased Simvastatin decreases the level of Triglycerides in the blood Simvastatin Approved LDL cholesterol decreased Simvastatin decreases the level of LDL cholesterol in the blood