Fenofibrate Treatment Equally Effective in Women and Men With Diabetes

Gendron Recheche, #Cancer

Fenofibrate, the blood-fat lowering drug, is equally effective in women with type 2 diabetes and in men with type 2 diabetes, shows a new research published in iDiabetologia/i (the journal of the European Association for the Study of Diabetes). The research is by the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study investigators in Australia, New Zealand and Finland, led by Professor Anthony Keech from the Clinical Trials Centre at the University …

http://dlvr.it/6hKvjq
Lipid lowering agents

Bile acid sequestrans (cholestyramine and colestipol)

- MOA: positively charged large molecules that bind negatively charged bile acids.

- Effects on lipids: LDL reduction is dose dependent, triglycerides may increase transiently, HDL increase (4-5%)

-S/E: GI intolerance

Niacin

- MOA: inhibits lipolysis of triglycerides by hormone-sensitive lipase. In the liver reduces triglyceride synthesis by inhibiting synthesis and esterification of fatty acids (increase ApoB degradation)

- Effect on lipids: reduces triglycerides (35-50%), reduces LDL (25%), HDL increases (more in pts with low HDL levels to begin with)

-S/E: flushing, dyspepsia, can reactivite PUD, hepatotoxicity

Fibric acid derivatives (fenofibrate, gemfibrozil)

- MOA: remains unclear, ?PPAR isotype

- Effects on lipids: depends on starting lipid levels, genetic hyperliproteinemia. Type III hyperliproteinemia are among most sentivite (triglyceride and cholesterol levels are lowered, xanthomas regress, angina/claudication improve). Mild hypertriglyceridemia can decrease triglycerides by 50% increase HDL 15%, LDL is unchanged. Higher triglycerides (400-1000 mg/dl), triglycerides fall but LDL increases

- S/E: GI intolerance, rash, hairloss, myalgias, fatigue, headache, impotence, anemia. Potentiate effects of anticoagulants

Ezetimibe

- MOA: inhibits luminal cholesterol uptake by jejunal enterocytes by inhibiting NPC1L1

- Effect on lipids: decrease LDL by 15-20%. Combination with statin leads to greater decrease in LDL than by either product alone.ย 

-S/E: no specific adverse effects.

statins

- MOA: competitively inhibits HMG-CoA reductase (inhibits rate limiting step of cholesterol biosynthesis)

- Effect on lipids: decreases LDL, triglycerides >250 are decreased, small increase in HDL

-S/E: hepatotoxicity, myopathy

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