Efficacy And Safety Of Combinations Of Different Lipid-lowering Drugs In The Patients With Mixed Hyperlipidemia

AIM: To evaluate the efficacy and safety of three different lipid-lowering drugs combination therapies including ezetimibe combined with fenofibrate,atorvastatin combined with ezetimibe and atorvastatin combined with fenofibrate in the patients with mixed hyperlipidemia.Methods:A total of 128 patients with mixed hyperlipidemia were randomized into three groups according to the proportion of 1:2:2,Group A(n=24,ezetimibe 10 mg qd+fenofibrate 200 mg qn),Group B(n=54,atorvastatin 10 mg qn+ezetimibe 10 mg qd),Group C(n=50,atorvastatin 10 mg qn+fenofibrate 200 mg qd),treatment lasted for 8 weeks.The changes of total cholesterol(TC),triglycerides(TG),high density lipoprotein-Cholesterol(HDL-C)and low-density lipoprotein-Cholesterol(LDL-C)were measured before and after treatment for 8 weeks,adverse reactions and the changes of alanine aminotransferase(ALT),aspartate aminotransferase(AST)and creatine kinase(CK)were observed at the same time.Results: After treatment for 8 weeks,the levels of TC,LDL-C,TG and non-HDL-C were significantly decreased and HDL-C was significantly increased in 3 groups(P<0.05).The decrease of TG in group A(ezetimibe +fenofibrate)and group C(atorvastatin +fenofibrate)was greater than that in group B(atorvastatin +ezetimibe)(48.31±19.41% and 46.39±20.46% vs 36.43±18.03%,P<0.05)).While group B(atorvastatin +ezetimibe)was better in reducing LDL-C than that of group A(ezetimibe +fenofibrate)and group C(atorvastatin +fenofibrate)(43.61±17.92% vs 25.70±34.22% and 28.97±16.60%,P<0.05).Compared with group C(atorvastatin +fenofibrate),the decrease of TC and non-HDL-C in group B(atorvastatin +ezetimibe)was greater(P<0.05),as well as the achievement ration of LDL-C and both of LDL-C and non-HDL-C were higher(P<0.05).No significant difference was found betweengroup A(ezetimibe +fenofibrate)and group C(atorvastatin +fenofibrate)(P>0.05).No serious adverse reactions such as rhabdomyolysis were observed.There was no significant difference in the incidence of adverse reactions such as gastrointestinal symptoms,myalgia/myositis,and ALT/AST elevation among the three groups(P>0.05),and the adverse reactions rates were 18.52%,22.41% and 20.00% in three groups,respectively(P>0.05).Conclusion: Combinations of different lipid-lowering drugs can regulating the level of dyslipidemia in the patients with mixed hyperlipidemia.The choice of combination therapies should be individualized.