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| | Lipids Online Slides: fibrate therapy, gemfibrozil, VA-HIT, HDL |
 | | A comparison of the two fibrate trials with the Lipoprotein and Coronary Atherosclerosis Study (LCAS) suggests that statin therapy is at least as beneficial as fibrate therapy in low-HDL-C patients. | | | In a comparison of LCAS with angiographic trials of fibrate therapy conducted in patients with low HDL-C, statin therapy produced at least as much benefit on CAD progression in low-HDL-C patients as fibrate therapy. | | | In clinical trials of fibrate therapy, most of the data are on secondary prevention. |
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http://www.lipidsonline.org/slides/slide01.cfm?q=fibrate+therapy
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| | Bodybuilding.com - Spook - Fibrates For The Bodybuilder! |
| | For some reason fibrates are not often discussed in bodybuilding literature; I would like to change that as I feel these compounds have tremendous potential to aid in one's body composition goals. | | | Fibrates do this as well, however they are much more effective. | | | Fibrates are of benefit because they help take care of the last problem: oxidation. |
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http://www.bodybuilding.com/fun/par35.htm
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| | Fibrate-induced Renal Dysfunction: Is Gemfibrozil the Only Non-nephrotoxic Agent ? |
| | An increase of mean creatinine values during therapy was described in all reports on bezafibrate and fenofibrate (range: 9 to 40% and 8 to 18% respectively). | | | It increased by a mean of 50% (range: 14 to 150%) within 1 to 3 months after the start of fibrate therapy. | | | To better characterize this side effect, 1) we reviewed the charts of 15 patients transplanted at our institution who experienced impaired renal function during fibrate therapy; 2) we made a literature search to analyse the articles giving data on renal function of patients treated by fibrates. |
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http://www.a-s-t.org/library/abstracts99/654.htm
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| | fibrate - General Practice Notebook |
| | Fibrates may interact significantly with anticoagulant therapy e.g. | | | Any response to fibrates, as for statins, is evident by four weeks and continuation or change can be reviewed (1). | | | fibrate therapy also leads to improved postprandial triglyceride clearance |
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http://www.gpnotebook.co.uk/cache/-107347890.htm
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| | Society of Cardiovascular Anesthesiologists |
| | Results: There were a total of 225,640 person-years of monotherapy with either a statin or a fibrate and 7,300 person-years of combined therapy with both a statin and a fibrate. | | | Comments: This is the first large-scale epidemiological study of rhabdomyolysis incidence associated with statin and fibrate therapy, focusing on rhabdomyolysis severe enough to require hospitalization. | | | The study demonstrates that, except for cerivastatin which has been withdrawn from the market, 13 the commonly prescribed statins (atorvastatin, simvastatin, and pravastatin) are associated with a very low incidence of rhabdomyolysis. |
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http://www.scahq.org/sca3/newsletters/2005feb/lit2.shtml
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| | Cholesterol drugs (Fibrate Warning: Tricor (fenofibrate) and Lopid (gemfibrozil))(Steve Harris, M.D.) |
| | It is counter-intuitive to most clinicians, however, and hence it can result in the misdirection of clinical efforts including drug therapy. | | | Their continued use is on the basis of tradition, which it's time we changed. | | | One hears a sort of wistful but supportive tone in the review articles, as though a mother were discussing her children's D+ grade report cards. |
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http://yarchive.net/med/cholesterol_drugs.html
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| | Polyunsaturated Ethyl Esters of n-3 Fatty Acids in HIV-Infected Patients With Moderate Hypertriglyceridemia: Comparison ... |
| | However, possible side effects and drug-drug interactions of antilipidemic drugs have to be taken into careful account, especially when antiretroviral drugs and other underlying pharmacologic therapies are of concern. | | | In our previous experiences, all administered fibrates and statins showed a similar efficacy in the therapy for HIV-associated mixed dyslipidemia, with no significant difference among the available fibrates (beza-fibrate, fenofibrate, and gemfibrozil) against hypertriglyceridemia. | | | Although recommendations regarding HIV-associated dyslipidemia have existed since 2000, only a reduced number of observational studies and controlled trials is available, and most problems regarding the long-term management of this untoward event remain unsolved. |
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http://www.natap.org/2004/HIV/062204_08.htm
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| | Statin-fibrate combination therapy -- Shek and Ferrill 35 (7): 908 -- The Annals of Pharmacotherapy |
| | The literature review demonstrated that combination therapy with a statin and fibrate increases the risk of muscle damage, with an incidence of 0.12%. | | | CONCLUSIONS: Combination therapy with a statin and fibrate offers significant therapeutic advantage for the treatment of severe or refractory mixed hyperlipidemia. | | | Although such a combination does increase the risk of myopathy, with an incidence of approximately 0.12%, this small risk of myopathy rarely outweighs the established morbidity and mortality benefits of achieving lipid goals. |
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http://www.theannals.com/cgi/content/abstract/35/7/908
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| | Stakeholder Insight: Dyslipidemia - Titration versus Combination Therapy: Table of Contents |
| | Figure 95: Breakdown of fibrate prescribing by compound in overall dyslipidemia patients in the seven major markets, 2003 | | | Table 70: Breakdown of fibrate use by compound | | | Figure 103: Proportion of drug-treated dyslipidemia patients in each sub-population receiving combination therapy in the seven major markets, 2003 |
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http://www.market-research-report.com/datamonitor/DMHC1945.htm
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| | fibrate, Primary Sclerosing Cholangitis Literature |
| | Fazio S, Linton MF 2004 The role of fibrates in managing hyperlipidemia: mechanisms of action and clinical efficacy. | | | Farmer JA, Gotto AM Jr 1995 Currently available hypolipidaemic drugs and future therapeutic developments. | | | Miller DB, Spence JD 1998 Clinical pharmacokinetics of fibric acid derivatives (fibrates). |
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http://www.psc-literature.org/fibrate.htm
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| | World Intellectual Property Organization |
| | Should also be stressed the fact that following a conventional, for example, alternate day administration of the medicaments, by means of standard commercial packages of statins and fibrates, a patient has to bear in mind which of the drugs received the preceding day. | | | Thus patient's coherence to treatment is hard to achieve. | | | For example: statin on"Day 1""Bedtime"and fibrate on"Day 2" "Lunch". |
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http://www.wipo.int/ipdl/IPDL-CIMAGES/view/pct/getbykey5?KEY=01/37831.010531&ELEMENT_SET=DECL
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| | ScienceDaily.com Content: The 15-Minute Visit |
| | Combinations of statins and fibrates should be used with caution, as there is a slightly increased risk of myopathy, which can be avoided by close monitoring and patient education. | | | To reach his goal, he will likely need 3 lipid-lowering drugs (a statin and a fibrate plus either ezetimibe or niacin) or 2 drugs plus intensive dietary changes. | | | Because of the possibility of drug interactions and side effects, the patient would have to be monitored closely. |
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http://sciencedaily.mediwire.com/main/Content.aspx?ArticleID=110035
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| | Changes in Cholesterol Values Using Statin and Fibrate Therapy |
| | The effects of statin (Zocor, Lipitor, Pravachol, Lescol, Advicor) and fibrate (Tricor) therapy on cholesterol and triglyceride levels were investigated in an effort to determine trends for an expanded research project. | | | Changes in Cholesterol Values Using Statin and Fibrate Therapy | | | Future research will include the influences of statin and fibrate therapy on arterial inflammatory markers. |
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http://aahperd.confex.com/aahperd/2004/preliminaryprogram/abstract_5626.htm
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| | Lipids Online Slides: rhabdomyolysis, combination therapy, statins |
| | Dose the fibrate in the morning and the statin in the evening (note that this suggestion is based on theoretical considerations and not on any evidence that this recommendation will reduce the incidence of muscle toxicity). | | | Combination Lipid-altering Drug Therapy with Statins: An Update (Harold Bays, MD, FACP) | | | Combination therapy is more expensive and is associated with increased adverse events such as rhabdomyolysis. |
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http://www.lipidsonline.org/slides/slide01.cfm?q=rhabdomyolysis
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| | The Bottom Line - Case WM |
| | Although no head-to-head studies have compared the incidence of myopathy/rhabdomyolysis in patients treated with pravastatin and other statins in combination with fibrates, pravastatin offers some differences among other marketed statins because it does not enter the myocyte. | | | In addition, fenofibrate may have a lowered risk of rhabdomyolysis than gemfibrozil and would be the fibrate of choice in this situation. | | | states that statin treatment alone or fibrate treatment alone is associated with a small risk of severe myopathy (approximately 0.8% to 0.9%), and that the risk is increased when a statin and a fibrate are used in combination. |
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http://jeffline.tju.edu/diabetes/newsletters/TheBottomLine/case2/q08.html
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| | JAMA News Releases - November 30, 2004 |
| | David J. Graham, M.D., M.P.H., from the Food and Drug Administration, and colleagues, analyzed claims data from 11 managed care health plans across the United States for patients on statins alone (monotherapy) or combined statin-fibrate therapy between January 1, 1998 and June 30, 2001. | | | "For the combination therapy of cerivastatin plus fibrate, the risk of rhabdomyolysis was increased over 1400 fold. | | | For patients treated with both statins and fibrates combined, such as persons with diabetes mellitus with elevated cholesterol and triglyceride levels, the higher risk conferred by combination therapy may warrant that physicians instruct their patients to stop therapy and be evaluated if symptoms suggestive of rhabdomyolysis develop." |
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http://pubs.ama-assn.org/media/2004jer/1130.dtl
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| | Incidence and risk factors of statin or fibrate-induced hepatitis and myositis in HIV-infected patients |
| | Background from authors: Due dyslipidemia (elevated cholesteroland triglycerides) associated with HAART doctors use statin and fibrate drugs to reduce cholesterol and triglycerides. | | | Concurrent protease inhibitor therapy may increase the risk of developing statin or fibrate induced hepatitis and myositis. | | | :The incidence of hepatitis or myositis in HIV-infected patients receiving a statin or fibrate is higher than in non-HIV patients. |
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http://www.natap.org/2000/lipo/incidence_and_risk120600.htm
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| | Fibrate -- Facts, Info, and Encyclopedia article |
| | Fibrates are structurally and pharmocologically related to the (Click link for more info and facts about thiazolidinedione) thiazolidinediones, a novel class of (Click link for more info and facts about anti-diabetic drug) anti-diabetic drugs that also act on (Click link for more info and facts about PPARs) PPARs (more specifically PPARγ) | | | Most fibrates can cause mild stomach upset and (Any pathology of the muscles that is not attributable to nerve dysfunction) myopathy (muscle pain with (Click link for more info and facts about CPK) CPK elevations). | | | Fibrates are used as accessory therapy in many forms of (The presence of an abnormal amount of cholesterol in the cells and plasma of the blood; associated with the risk of atherosclerosis) hypercholesterolemia, usually in combination with (A medicine that lowers blood cholesterol levels by inhibiting HMG-CoA reductase) statins. |
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http://www.absoluteastronomy.com/encyclopedia/f/fi/fibrate.htm
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| | Fibrate Drugs |
| | Although no such interactions have yet been reported, it is at least theoretically possible that combined use of these herbs and fibrate drugs could pose a risk of bleeding problems. | | | Fibrate drugs are known to increase the "blood thinning" effects of drugs in the warfarin (Coumadin) family. | | | Fibrate drugs are known to raise homocysteine levels in the blood. |
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http://healthlibrary.epnet.com/GetContent.aspx?token=e0498803-7f62-4563-8d47-5fe33da65dd4&chunkiid=21669
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| | Statin - Wikipedia, the free encyclopedia |
| | A 2004 study (Graham et al) found that of 10,000 patients treated for one year, 0.44 will develop this side-effect. | | | As up to 50% of all circulating cholesterol originates in the diet, doctors in theory only prescribe statins after dietary intervention has not had the desired effect. | | | Most physicians have now abandoned routine monitoring of liver enzymes and creatine kinase, although they still consider this prudent in those on high-dose statins or in those on statin/fibrate combinations, and mandatory in the case of muscle cramps or of deterioration in renal function. |
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http://en.wikipedia.org/wiki/Statin
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| | ISA: Combined Fluvastatin-Fibrate Therapy Improves Lipid Profile of Hypercholesterolaemic Patients |
| | Farnier concluded that the most important aspect of this study is the safety of combining fluvastatin with a fibrate. | | | He stated that this treatment is effective and should be considered for high-risk patients with combined hyperlipidaemia who do not respond to fluvastatin alone. | | | The greatest percent reduction in LDL and other non-HDL cholesterol occurred in the subgroup of patients who had a baseline triglyceride level of less than 150 mg/dL. |
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http://www.pslgroup.com/dg/23b286.htm
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| | Science, Politics and Ethics » [USA] Time for an independent drug surveillance agency? |
| | Given that there had been a suspected connection between simultaneous statin and fibrate use and rhabdomyolysis, it is not clear that such a general warning would have raised any red flags in the medical community. | | | In May 1998 Bayer knew that “5 of 6 US cerivastatin-associated rhabdomyolysis suspected adverse drug results (SADRs) occurred in patients also taking gemfibrozil". | | | Yet in the warning added in July 1998 there was only a general warning about using cerivastatin in combination with fibrates (the general class of drug for gemfibrozil). |
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http://politics.scienceboard.net/archives/2004/12/07/17
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| | Fibrate trials |
| | Bezafibrate therapy resulted in a 40% reduction (P = 0.03) in the combined primary end point (fatal or nonfatal myocardial infarction and sudden death) in a subgroup of patients (15% of the study population; n = 459) with baseline triglyceride (TG) levels | | | 2.26 mmol/L Thus, although statins appear to be superior to fibrates in the treatment of moderate hyperlipidemia, there may be a case for the use of fibrates in patients with TG levels |
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http://www.guthormones.co.uk/fibrate%20trials.htm
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| | Prevention, Secondary |
| | If triglycerides are 200–499 mg/dL: Consider fibrate or niacin* after lipid-lowering therapy.** | | | Consider combined drug therapy (statin + fibrate or niacin*) (if low HDL or high triglycerides). | | | If triglycerides are 500 mg/dL or higher: Consider fibrate or niacin* before LDL-lowering therapy.** Consider omega-3 fatty acids as adjunct for high triglycerides. |
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http://www.americanheart.org/presenter.jhtml?identifier=4723
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| | BrainTalk Communities - Is anybody here on cholesterol lowering drugs? My mother is... |
| | This the link to an abstract of a German medical journal article on myopathies caused by Statin drugs: | | | Because of the similar clinical symptomatology with muscle aches and increased stiffness, the diagnosis of statin-induced aggravated Parkinson Disease Syndrome should be discussed. | | | However, they should be administered with caution.The risk of fibrate/statine myopathy, the most common side effect of fibrate/statine therapy, increases with dosage, combination of a fibrate with a statine,hypothyroidism, renal insufficiency, and intake of cytochrome P450 inhibitors. |
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http://brain.hastypastry.net/forums/showthread.php?t=65410
(2420 words)
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| | Fibrate - Wikipedia, the free encyclopedia |
| | Fibrates are used as accessory therapy in many forms of hypercholesterolemia, usually in combination with statins. | | | Fibrates are structurally and pharmocologically related to the thiazolidinediones, a novel class of anti-diabetic drugs that also act on PPARs (more specifically PPARγ) | | | Most fibrates can cause mild stomach upset and myopathy (muscle pain with CPK elevations). |
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http://en.wikipedia.org/wiki/Fibrate
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| | Lipid Education Program |
| | Consider using niacin in addition to a fibrate if the patient is non-diabetic. | | | Is patient already taking a fibrate or cyclosporine? | | | Intensify treatment for secondary disorders, such as diabetes. |
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http://www.intmed.mcw.edu/gimcme/lipids
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| | fibrate |
| | Combined Statin and Fibrate (or Niacin) Treatment Instructions | | | Three fibrates are licensed for use in the US (as of 2002): These are lofibrate, gemfibrozil, and fenofibrate. | | | The fibrates are a class of cholesterol-lowering pharmaceuticals, mostly effective in lowering triglycerides, but also raise HDL-cholesterol. |
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http://www.fact-library.com/fibrate.html
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| | Alembic |
| | However, combination therapy with these agents has been attenuated by concern emanating from reports of treatment-induced myopathy with the combination of lovastatin and gemfibrozil, and more recently, myopathy-rhabdomyolysis reported with cerivastatin and gemfibrozil. | | | Because of their complementary effects on lipid parameters, statin and fibrate combination therapy offers the potential to achieve a better overall lipid profile compared to either agent used alone. | | | One strategy to meet the challenge of managing diabetic dyslipidemia would be combination therapy with a statin and a fibrate. |
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http://www.indegene.com/main/info/alembic/indemag.html
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| | Safety of statins, fibrates assessed |
| | Per year of therapy, the number needed to treat to observe 1 case of rhabdomyolysis was 22,727 for statin monotherapy, 484 for older patients with diabetes mellitus who were treated with both a statin and fibrate, and ranged from 9.7 to 12.7 for patients who were treated with cerivastatin plus fibrate.” | | | The incidence increased to 5.98 (95% CI, 0.72–216.0) for combined therapy of atorvastatin, pravastatin, or simvastatin with a fibrate, and to 1035 (95% CI, 389–2117) for combined cerivastatin–fibrate use. | | | Based on analysis of claims data from 11 managed care plans in 1998–2001, the authors found, “In 252,460 patients treated with lipid-lowering agents, 24 cases of hospitalized rhabdomyolysis occurred during treatment. |
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http://www.pharmacist.com/articles/h_ts_0675.cfm
(508 words)
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| | IngentaConnect Influence of fibrate treatment on malondialdehyde-modified LDL co... |
| | Influence of fibrate treatment on malondialdehyde-modified LDL concentration | | | IngentaConnect Influence of fibrate treatment on malondialdehyde-modified LDL co... | | | You may be required to register and activate access/purchase before you can obtain the full text. |
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http://www.ingentaconnect.com/content/els/00098981/2004/00000339/00000001/art00446
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