EFFICACY OF STATIN MONOTHERAPY VERSUS STATIN–FIBRATE COMBINATION THERAPY IN TYPE 2 DIABETES MELLITUS
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Keywords
Type 2 diabetes mellitus, dyslipidemia, statin, fibrate, atorvastatin, fenofibrate, lipid profile, combination therapy.
Abstract
Introduction: One of the most common metabolic complications of type 2 diabetes mellitus (T2DM) is dyslipidemia with elevated risks of cardiovascular disease. Statins are the treatment of choice, but residual hypertriglyceridemia and HDL-C often remain, and combination therapy with fibrates is then indicated.
Objective: To compare the efficacy of statin monotherapy versus statin–fibrate combination therapy in improving lipid profiles in T2DM patients with dyslipidemia at Ayub Teaching Hospital Abbottabad, Pakistan.
Material and Method: The study was a prospective, randomized, and open-label study that was carried out from August, 2020 to January, 2021 at Ayub Teaching Hospital Abbottabad, Pakistan. A total of 120 eligible T2DM patients with dyslipidemia were randomized into two arms atorvastatin 20 mg daily (Group A) or atorvastatin 20 mg and fenofibrate 145 mg daily (Group B). The lipid parameters were assessed at the initiation point and the end of the 12 weeks.
Results: There was a substantial improvement in the lipid profile in both groups. Further decrease in the total cholesterol (26.0% 18.6%), LDL-C (30.5% vs 23.2%), triglycerides (32.4% vs 15.2%), and a rise in the HDL-C (22.4 % vs12.5 %) were greater in the combination group. Side effects were minimal and self-limited.
Conclusion: Combination therapy of statin and fibrate is better in lipid control than statin monotherapy in treating mixed dyslipidemia, with good tolerability in T2DM.
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Dr. Muhammad Salman Khan
Postgraduate Resident Physician (FCPS Medicine) Department of Medicine, Ayub Teaching Hospital Abbottabad, Pakistan.
Dr. Hassan Ejaz
Postgraduate Resident (FCPS Medicine), Department of Medicine, Combined Military Hospital (CMH), Abbottabad, Pakistan.
Dr. Sher Alam Khan
Postgraduate Resident (FCPS Paediatrics), Department of Paediatrics, Combined Military Hospital (CMH), Abbottabad, Pakistan.