Effects of fenofibrate and ezetimibe, both as monotherapy and in coadministration, on cholesterol mass within lipoprotein subfractions and low-density lipoprotein peak particle size in patients with mixed hyperlipidemia.

Description

In order to compare the effects of fenofibrate and ezetimibe on lipoprotein subfractions and LDL peak particle size, both as monotherapy or in coadministration, Tribble et al. performed a 12-week, multicentre, randomized, double-blind, placebo-controlled trial in patients with mixed hyperlipidemia. Patients were randomized in a 1:3:3:3 ratio to 1 of 4 treatment groups: placebo (n=58-59), fenofibrate 160 mg/day (n=167-170), ezetimibe 10 mg/day (170-176), or a combination of fenofibrate 160 mg/day and ezetimibe 10 mg/day (170-171). Lipoprotein concentrations and LDL subfractions were measured using the Vertical Auto Profile II method. Fenofibrate reduced cholesterol mass within VLDL cholesterol, IDL cholesterol, and within the dense subfraction of LDL, whereas it increased cholesterol levels in the more buoyant LDL subfraction. Fenofibrate also increased LDL peak particle size by approximately 13 Å. Ezetimibe decreased VLDL, IDL, and LDL cholesterol, but had no effect on LDL size. The coadministration of fenofibrate and ezetimibe was well tolerated and produced complementary effects on lipoprotein concentrations and LDL subfractions, suggesting that the fenofibrate and ezetimibe combination may be of potential benefit in patients with mixed hyperlipidemia.