Statins and fibrates are two types of hypolipidemic agents with different mechanisms of action: statins inhibit the synthesis of cholesterol and upregulate the LDL receptor gene, whereas fibrates activate a member of the peroxisome proliferator-activated receptor (PPAR) family. Synergistic effects have been described for statins and fibrates on the transcriptional activity of PPARs and the transactivation of NF-kB (Inoue, I. et al. Biochem Biophys Res Commun 2002, 290(1): 131). Studies discussed at the ongoing EAS congress in Salzburg (Austria) provided new data that support the use of a combination of statins and fibrates in the treatment for hyperlipidemia and dyslipidemia. The differential regulation of lipoprotein metabolism by atorvastatin and fenofibrate was assessed in a double-blind, randomized, crossover study in 11 subjects with mild dyslipidemia. Treatment with either 40 mg/day atorvastatin or 200 mg/day micronized fenofibrate resulted in different effects on the lipid profile and the kinetics of apolipoprotein A-I or apolipoprotein B-100, supporting the use of combination therapy for optimal effects on lipoprotein metabolism (Watts, G.F. et al. 73rd Eur Atherosclerosis Soc [EAS] Cong (July 7-10, Salzburg) 2002, Abst 270).
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