PPARα Agonists: New Evidence on Their Effects in Atherogenic Dyslipidemia and Inflammatory Markers

Sponsored by an unrestricted educational grant from Abbott Laboratories

Faculty:
Jorge Plutzky, MD
John Buse, MD
Peter Jones, MD

Friday, June 4, 2004
6:00 pm – 10:00 pm

Reviewed by Joelle Escoffery, PhD

This program reviewed findings regarding the use of statin, fibrate, and statin-fibrate combination therapy in the reduction of CVD risk and mortality and the treatment of atherogenic dyslipidemia in patients with type 2 diabetes and metabolic syndrome.

In monotherapy, statins and fibrates reduce LDL cholesterol, increase HDL cholesterol, increase LDL particle size, and reduce triglycerides. But could these reductions be taken a step further with combination therapy? The pros of combination therapy include those parameters improved with monotherapy and decreased fibrinogen and reduced uric acid. The cons, however, are extremely serious and include an increased risk of hepatic transaminases (eg, ALT) and muscular symptoms (eg, myositis, rhabdomyolysis).

Past trials (eg, HHS, VA-HIT, BIP) have suggested that statin-fibrate combination therapy reduces the risk of CVD. Results from the ACCORD trial are eagerly awaited as it may finally confirm whether combination therapy in diabetics at risk for CVD is better than statin monotherapy.