Optimal pharmacologic approach to patients with hypertriglyceridemia and low high-density lipoprotein-cholesterol: Randomized comparison of fenofibrate 160mg and niacin 1500mg

Jin Wi, Jong Youn Kim, Sungha Park, Seok Min Kang, Yangsoo Jang, Namsik Chung, Won Heum Shim, Seung Yun Cho, Sang Hak Lee

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Objectives: Atherogenic dyslipidemia is emerging as a target of lipid-modifying therapy. However, an optimal pharmacologic approach has not yet been established. The aim of this study is to compare the efficacy and tolerability of the typical doses of fenofibrate and niacin. Methods: After an eight-week dietary run-in, 201 patients who had triglyceride (TG) levels of 150-499 mg/dL, high-density lipoprotein-cholesterol (HDL-C) levels of <45 mg/dL and low-density lipoprotein-cholesterol (LDL-C) levels of <130 mg/dL were randomly assigned to one of two treatment groups for 16 weeks: fenofibrate 160 mg or niacin extended release 1500 mg (starting at 500 mg and up-titrated at the fifth and ninth weeks). Results: One hundred forty patients completed the study. The percent reductions in apoB/A1 were not different between the two groups (-20% and -22% in the fenofibrate and niacin groups, respectively, p= 0.47). The effects of the two regimens on HDL-C were similar (24% and 20%, respectively, p= 0.22), while fenofibrate reduced TG more than did niacin (-53% and -48%, respectively, p= 0.045). Niacin was more effective at lowering LDL-C, Lp (a), and hs-CRP. However, niacin worsened the parameters of glycemic control, whereas fenofibrate improved them. Niacin showed more frequent adverse events including pruritus and skin flushing. Conclusions: These two regimens have largely comparable lipid-modifying effects. However, their effects on glucose metabolism and inflammation, and their adverse events need to be considered additionally. Our results underscore more individualized pharmacologic approaches to patients with atherogenic dyslipidemia.

Original languageEnglish
Pages (from-to)235-240
Number of pages6
JournalAtherosclerosis
Volume213
Issue number1
DOIs
Publication statusPublished - 2010 Nov 1

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Fenofibrate
Hypertriglyceridemia
Niacin
LDL Cholesterol
HDL Cholesterol
Dyslipidemias
Triglycerides
Lipids
Apolipoproteins B
Pruritus
Inflammation
Glucose
Skin
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Optimal pharmacologic approach to patients with hypertriglyceridemia and low high-density lipoprotein-cholesterol: Randomized comparison of fenofibrate 160mg and niacin 1500mg",
abstract = "Objectives: Atherogenic dyslipidemia is emerging as a target of lipid-modifying therapy. However, an optimal pharmacologic approach has not yet been established. The aim of this study is to compare the efficacy and tolerability of the typical doses of fenofibrate and niacin. Methods: After an eight-week dietary run-in, 201 patients who had triglyceride (TG) levels of 150-499 mg/dL, high-density lipoprotein-cholesterol (HDL-C) levels of <45 mg/dL and low-density lipoprotein-cholesterol (LDL-C) levels of <130 mg/dL were randomly assigned to one of two treatment groups for 16 weeks: fenofibrate 160 mg or niacin extended release 1500 mg (starting at 500 mg and up-titrated at the fifth and ninth weeks). Results: One hundred forty patients completed the study. The percent reductions in apoB/A1 were not different between the two groups (-20{\%} and -22{\%} in the fenofibrate and niacin groups, respectively, p= 0.47). The effects of the two regimens on HDL-C were similar (24{\%} and 20{\%}, respectively, p= 0.22), while fenofibrate reduced TG more than did niacin (-53{\%} and -48{\%}, respectively, p= 0.045). Niacin was more effective at lowering LDL-C, Lp (a), and hs-CRP. However, niacin worsened the parameters of glycemic control, whereas fenofibrate improved them. Niacin showed more frequent adverse events including pruritus and skin flushing. Conclusions: These two regimens have largely comparable lipid-modifying effects. However, their effects on glucose metabolism and inflammation, and their adverse events need to be considered additionally. Our results underscore more individualized pharmacologic approaches to patients with atherogenic dyslipidemia.",
author = "Jin Wi and Kim, {Jong Youn} and Sungha Park and Kang, {Seok Min} and Yangsoo Jang and Namsik Chung and Shim, {Won Heum} and Cho, {Seung Yun} and Lee, {Sang Hak}",
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Optimal pharmacologic approach to patients with hypertriglyceridemia and low high-density lipoprotein-cholesterol : Randomized comparison of fenofibrate 160mg and niacin 1500mg. / Wi, Jin; Kim, Jong Youn; Park, Sungha; Kang, Seok Min; Jang, Yangsoo; Chung, Namsik; Shim, Won Heum; Cho, Seung Yun; Lee, Sang Hak.

In: Atherosclerosis, Vol. 213, No. 1, 01.11.2010, p. 235-240.

Research output: Contribution to journalArticle

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T1 - Optimal pharmacologic approach to patients with hypertriglyceridemia and low high-density lipoprotein-cholesterol

T2 - Randomized comparison of fenofibrate 160mg and niacin 1500mg

AU - Wi, Jin

AU - Kim, Jong Youn

AU - Park, Sungha

AU - Kang, Seok Min

AU - Jang, Yangsoo

AU - Chung, Namsik

AU - Shim, Won Heum

AU - Cho, Seung Yun

AU - Lee, Sang Hak

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N2 - Objectives: Atherogenic dyslipidemia is emerging as a target of lipid-modifying therapy. However, an optimal pharmacologic approach has not yet been established. The aim of this study is to compare the efficacy and tolerability of the typical doses of fenofibrate and niacin. Methods: After an eight-week dietary run-in, 201 patients who had triglyceride (TG) levels of 150-499 mg/dL, high-density lipoprotein-cholesterol (HDL-C) levels of <45 mg/dL and low-density lipoprotein-cholesterol (LDL-C) levels of <130 mg/dL were randomly assigned to one of two treatment groups for 16 weeks: fenofibrate 160 mg or niacin extended release 1500 mg (starting at 500 mg and up-titrated at the fifth and ninth weeks). Results: One hundred forty patients completed the study. The percent reductions in apoB/A1 were not different between the two groups (-20% and -22% in the fenofibrate and niacin groups, respectively, p= 0.47). The effects of the two regimens on HDL-C were similar (24% and 20%, respectively, p= 0.22), while fenofibrate reduced TG more than did niacin (-53% and -48%, respectively, p= 0.045). Niacin was more effective at lowering LDL-C, Lp (a), and hs-CRP. However, niacin worsened the parameters of glycemic control, whereas fenofibrate improved them. Niacin showed more frequent adverse events including pruritus and skin flushing. Conclusions: These two regimens have largely comparable lipid-modifying effects. However, their effects on glucose metabolism and inflammation, and their adverse events need to be considered additionally. Our results underscore more individualized pharmacologic approaches to patients with atherogenic dyslipidemia.

AB - Objectives: Atherogenic dyslipidemia is emerging as a target of lipid-modifying therapy. However, an optimal pharmacologic approach has not yet been established. The aim of this study is to compare the efficacy and tolerability of the typical doses of fenofibrate and niacin. Methods: After an eight-week dietary run-in, 201 patients who had triglyceride (TG) levels of 150-499 mg/dL, high-density lipoprotein-cholesterol (HDL-C) levels of <45 mg/dL and low-density lipoprotein-cholesterol (LDL-C) levels of <130 mg/dL were randomly assigned to one of two treatment groups for 16 weeks: fenofibrate 160 mg or niacin extended release 1500 mg (starting at 500 mg and up-titrated at the fifth and ninth weeks). Results: One hundred forty patients completed the study. The percent reductions in apoB/A1 were not different between the two groups (-20% and -22% in the fenofibrate and niacin groups, respectively, p= 0.47). The effects of the two regimens on HDL-C were similar (24% and 20%, respectively, p= 0.22), while fenofibrate reduced TG more than did niacin (-53% and -48%, respectively, p= 0.045). Niacin was more effective at lowering LDL-C, Lp (a), and hs-CRP. However, niacin worsened the parameters of glycemic control, whereas fenofibrate improved them. Niacin showed more frequent adverse events including pruritus and skin flushing. Conclusions: These two regimens have largely comparable lipid-modifying effects. However, their effects on glucose metabolism and inflammation, and their adverse events need to be considered additionally. Our results underscore more individualized pharmacologic approaches to patients with atherogenic dyslipidemia.

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