Changing perceptions about the role of combination therapy with statin and fibrate in patients with hypertriglyceridemia

Q4 Medicine
S. R. Gilyarevskiy
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引用次数: 0

Abstract

The article discusses the modern therapeutic approach to lowering blood triglyceride levels. The need to consider indications for the use of lipid-lowering therapy in patients with hypertriglyceridemia is caused by the emergence of new evidence-based information. The article describes how elevated blood TG levels are associated with the risk of developing cardiovascular (CV) complications, as well as pancreatitis. The mechanisms of TG metabolism that may regulate the relationship between elevated blood TG levels and the risk of developing CV complications are considered. The findings of large randomized clinical trials, including recent ones, which laid the foundation for the current clinical guidelines for the use of drugs to lower triglycerides levels, are discussed. Indications for fibrate therapy in patients with elevated blood TG levels in various clinical situations are considered. The article emphasizes that the icosapent ethyl ester drug is not currently available in the Russian Federation. According to the latest versions of international guidelines, it is considered a first-line drug to reduce the risk of developing CV complications in patients with an established diagnosis of CVD (i.e. for the purpose of secondary prevention). In this context, the significance of fenofibrate as a drug to lower blood triglyceride levels, specifically in secondary prevention of CV complications, can remain quite high in our country. The appearance of a rosuvastatin and fenofibrate combination drug on the pharmaceutical market of the Russian Federation will increase adherence to the therapy, if a fibrate is required to be added to statin therapy.
他汀类药物和贝特联合治疗高甘油三酯血症患者的作用观念的改变
本文讨论了降低血液甘油三酯水平的现代治疗方法。考虑高甘油三酯血症患者使用降脂治疗的适应症的需要是由新的循证信息的出现引起的。这篇文章描述了血TG水平升高与发生心血管(CV)并发症以及胰腺炎的风险之间的关系。本文考虑了TG代谢可能调节血TG水平升高与心血管并发症发生风险之间关系的机制。讨论了大型随机临床试验的结果,包括最近的研究结果,这些结果为目前使用药物降低甘油三酯水平的临床指南奠定了基础。贝特治疗的适应症患者升高血TG水平在各种临床情况下考虑。文章强调,目前在俄罗斯联邦还没有二十戊二乙酯类药物。根据最新版本的国际指南,它被认为是一线药物,可降低已确诊心血管疾病的患者发生心血管并发症的风险(即用于二级预防目的)。在这种情况下,非诺贝特作为一种降低血液甘油三酯水平的药物,特别是在心血管并发症的二级预防方面,在我国的重要性仍然很高。如果需要在他汀类药物治疗中添加贝特,那么俄罗斯联邦药品市场上出现瑞舒伐他汀和非诺贝特联合药物将增加对治疗的依从性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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