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Study Questions Rise in Use of Certain Cholesterol Drugs
Date:3/22/2011

ack of benefit shown in the two studies in diabetics, Dr. Jorge Plutzky, an American Heart Association spokesman and director of the Brigham and Women's Hospital vascular disease prevention program, said that fibrates remain an important option for some patients, particularly those who've had a heart attack already and/or have very high triglyceride levels (above 300 milligrams per deciliter of blood) and very low HDL (below 35 mg/dL).

And he believes that, in a deeper look at the data in the studies of diabetics in the subgroup of people with very high triglycerides and very low HDL, fibrates may be beneficial. In addition, some patients in those studies were also taking statins, which may have obscured the benefits they might have derived from fibrates, Plutzky said.

"When physicians see patients whose LDLs [cholesterol] are well-controlled, but who still have residual risk with elevated trigylcerides and low HDL, fibrates are a potential target for that," Plutzsky said. "The evidence has not been a strong as we would have liked, but there is also evidence I would not be willing to ignore."

Doctors typically choose fenofibrate over older, generic gemfibozil because the former is a once-a-day dose, while the latter has to be taken twice a day, he said, and people are more likely to take a once-a-day medication. Whether people take the generic or the brand name is usually determined by the insurance plan, he added.

Researchers stressed that this research is not about statins, which have been shown in numerous studies to reduce the chances of a heart attack by lowering LDL cholesterol.

They also emphasized that patients should continue taking their fibrates as prescribed and talk to their doctor if they have any questions, Jackevicius said.

Eating a healthy diet, exercising, losing weight and improving diabetes control can help also improve the cholesterol profile, the researchers said.

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