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fibric acid

Dawei Wang, Yanqiu Wang
RATIONALE: Fenofibrate is a fibric acid derivative indicated for use in hypertriglyceridemia and mixed dyslipidemia treatment among adults. Rhabdomyolysis is a syndrome characterized by muscle necrosis and the release of intracellular muscle contents into the systemic circulation, which is the most serious and fatal side effect of fenofibrate. The objective of this paper is to discuss fatal side effect of fenofibrate and keep safe medication. PATIENT CONCERNS: A patient with hypothyroidism who presented with rhabdomyolysis during fenofibrate monotherapy for hypertriglyceridemia was reported...
April 2018: Medicine (Baltimore)
Samantha Karr
Cardiovascular disease (CVD) is the leading cause of death among adults in the United States, and people with hyperlipidemia are at roughly twice the risk of developing CVD as compared to those with normal total cholesterol levels.1 Patients with familial hypercholesterolemia (FH) have an even greater risk of developing CVD at an earlier age; therefore, early detection and treatment are imperative to reduce cardiovascular events and premature death. Statins are the mainstay treatment for hyperlipidemia; however, the limitations of statins include treatment resistance, intolerance due to adverse events, and a lack of adherence which contribute to poor outcomes...
June 2017: American Journal of Managed Care
(no author information available yet)
Primary biliary cholangitis (PBC) is a chronic inflammatory autoimmune cholestatic liver disease, which when untreated will culminate in end-stage biliary cirrhosis. Diagnosis is usually based on the presence of serum liver tests indicative of a cholestatic hepatitis in association with circulating antimitochondrial antibodies. Patient presentation and course can be diverse and risk stratification is important to ensure all patients receive a personalised approach to their care. The goals of treatment and management are the prevention of end-stage liver disease, and the amelioration of associated symptoms...
July 2017: Journal of Hepatology
Jeffrey B Driban, Grace H Lo, Charles B Eaton, Kate L Lapane, Michael Nevitt, William F Harvey, Charles E McCulloch, Timothy E McAlindon
BACKGROUND: We conducted an exploratory analysis of osteoarthritis progression among medication users in the Osteoarthritis Initiative to identify interventions or pathways that may be associated with disease modification and therefore of interest for future clinical trials. METHODS: We used participants from the Osteoarthritis Initiative with annual medication inventory data between the baseline and 36-month follow-up visit ( n = 2938). Consistent medication users were defined for each medication classification as a participant reporting at all four annual visits that they were regularly using an oral prescription medication at the time of the visit...
December 2016: Therapeutic Advances in Musculoskeletal Disease
Yi-Heng Li, Kwo-Chang Ueng, Jiann-Shing Jeng, Min-Ji Charng, Tsung-Hsien Lin, Kuo-Liong Chien, Chih-Yuan Wang, Ting-Hsing Chao, Ping-Yen Liu, Cheng-Huang Su, Shih-Chieh Chien, Chia-Wei Liou, Sung-Chun Tang, Chun-Chuan Lee, Tse-Ya Yu, Jaw-Wen Chen, Chau-Chung Wu, Hung-I Yeh
In Taiwan, the prevalence of hyperlipidemia increased due to lifestyle and dietary habit changes. Low density lipoprotein cholesterol (LDL-C) and non-high density lipoprotein cholesterol (non-HDL-C) are all significant predicting factors of coronary artery disease in Taiwan. We recognized that lipid control is especially important in patients with existed atherosclerotic cardiovascular diseases (ASCVD), including coronary artery disease (CAD), ischemic stroke and peripheral arterial disease (PAD). Because the risk of ASCVD is high in patients with diabetes mellitus (DM), chronic kidney disease (CKD) and familial hypercholesterolemia (FH), lipid control is also necessary in these patients...
April 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
Amitkumar Patel, Anil Seetharam
Primary Biliary Cholangitis is a progressive, autoimmune cholestatic liver disorder. Cholestasis with disease progression may lead to dyslipidemia, osteodystrophy and fat-soluble vitamin deficiency. Portal hypertension may develop prior to advanced stages of fibrosis. Untreated disease may lead to cirrhosis, hepatocellular cancer and need for orthotopic liver transplantation. Classically, diagnosis is made with elevation of alkaline phosphatase, demonstration of circulating antimitochondrial antibody, and if performed: asymmetric destruction/nonsupperative cholangitis of intralobular bile ducts on biopsy...
December 2016: Journal of Clinical and Experimental Hepatology
Nidhi Agrawal, Patricia Freitas Corradi, Namrata Gumaste, Ira J Goldberg
Cholesterol reduction has markedly reduced major cardiovascular disease (CVD) events and shown regression of atherosclerosis in some studies. However, CVD has for decades also been associated with increased levels of circulating triglyceride (TG)-rich lipoproteins. Whether this is due to a direct toxic effect of these lipoproteins on arteries or whether this is merely an association is unresolved. More recent genetic analyses have linked genes that modulate TG metabolism with CVD. Moreover, analyses of subgroups of hypertriglyceridemic (HTG) subjects in clinical trials using fibric acid drugs have been interpreted as evidence that TG reduction reduces CVD events...
September 2016: Progress in Cardiovascular Diseases
Barbara S Wiggins, Joseph J Saseen, Pamela B Morris
Gemfibrozil is a lipid-modifying agent that belongs to the fibric acid derivative class. Fibric acid derivatives activate peroxisome proliferator activated receptor α (PPAR-α). The primary role of these agents in clinical practice is for the management of hypertriglyceridemia. Triglycerides may be reduced by as much as 74 % in some patients. In addition to lowering triglycerides, these agents can also decrease very low-density lipoprotein cholesterol (VLDL-C) and low-density lipoprotein cholesterol (LDL-C) as well as raise high-density lipoprotein cholesterol (HDL-C)...
April 2016: Current Atherosclerosis Reports
Melissa L Miller, Chanin C Wright, Barry Browne
As demonstrated by the 2011 publication of the National Heart, Lung, and Blood Institute Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, the information available regarding the treatment of pediatric lipid disorders has greatly expanded. HMG-CoA reductase inhibitor, or statin, therapy is now considered a first-line pharmacologic intervention for pediatric patients with severe dyslipidemias failing treatment with diet and exercise alone. Despite their ability to effectively reduce cholesterol levels, bile acid sequestrants continue to pose challenges for pediatric patients because of their unpalatability and are typically used as adjunctive therapy or for patients not able to tolerate statins...
September 2015: Journal of Clinical Lipidology
Dee Ann Stults Bragg, Anne Walling
Metabolic syndrome is associated with an elevated risk of cardiovascular disease and premature mortality. When metabolic syndrome includes lipid abnormalities, management goals are weight loss and cardiovascular risk management through lifestyle modifications (eg, diet, exercise), and, when appropriate, lowering of lipid levels with pharmacotherapy. Healthy diets are recommended, particularly the Mediterranean diet. Patients also should set a goal of at least 30 minutes of moderate to vigorous exercise on most, preferably all, days of the week...
August 2015: FP Essentials
Katherine S Rhodes, Martha Weintraub, Elizabeth H Marchlewicz, Melvyn Rubenfire, Robert D Brook
BACKGROUND: Patients with refractory severe hypertriglyceridemia are at risk of pancreatitis and cardiovascular disease. The role of individualized nutrition therapy in these patients independent of pharmaceutical treatment has not been documented. OBJECTIVE: To document the effect of nutrition intervention on severe hypertriglyceridemia regardless of medication status or prior nutrition counseling. METHODS: Outcomes of new patients with triglycerides ≥ 500 mg/dL presenting to a Lipid Management Program over a 6-year period were tracked...
July 2015: Journal of Clinical Lipidology
Daniel Gaudet, Veronica J Alexander, Brenda F Baker, Diane Brisson, Karine Tremblay, Walter Singleton, Richard S Geary, Steven G Hughes, Nicholas J Viney, Mark J Graham, Rosanne M Crooke, Joseph L Witztum, John D Brunzell, John J P Kastelein
BACKGROUND: Apolipoprotein C-III (APOC3) is a key regulator of plasma triglyceride levels. Elevated triglyceride levels are associated with a risk of adverse cardiovascular events and pancreatitis. ISIS 304801 is a second-generation antisense inhibitor of APOC3 synthesis. METHODS: We conducted a randomized, double-blind, placebo-controlled, dose-ranging, phase 2 study to evaluate ISIS 304801 in untreated patients with fasting triglyceride levels between 350 mg per deciliter (4...
July 30, 2015: New England Journal of Medicine
Robert Krysiak, Henryk Rudzki, Gabriela Handzlik-Orlik, Anna Gdula-Dymek, BogusŁaw Okopień
Peroxisome proliferator-activated receptor (PPAR)α activators (fibrates) are one of the major group of hypolipidemic agents, that have been presented to have clinical benefits in prevention and treatment of cardiovascular disorders. Apart from their well-known hypolipidemic properties, fibrates produce other so-called pleiotropic effects, including anti-inflammatory and anti-oxidant action, as well as reduction in procoagulant activity and improvement in endothelial function. These observations are in line with some of the results from large randomised clinical trials, which indicated the benefits from therapy with fibrates other than we could expect from their hypolipidemic properties...
April 2015: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
M S Rasin
All three types of peroxisome proliferation activating rexeptiors (PPAR): α, β/δ and γ, are sensors of fat acids and their derivatives and carry out the transcription adjusting of genes of exchange of lipids, including circulation of cholesterol and sensitiveness of tissues to insulin. They possess antiinflammatory properties, control activity of cells of the immune system, endothelia and smooth musculature of vessels. Such combination of functions does PPAR an ideal target for a prophylaxis and treatment of atherosclerosis...
May 2014: Likars'ka Sprava
F Hourcade-Potelleret, S Laporte, V Lehnert, P Delmar, Renée Benghozi, U Torriani, R Koch, P Mismetti
CONTEXT: Epidemiological evidence that the risk of coronary heart disease is inversely associated with the level of high-density lipoprotein cholesterol (HDL-C) has motivated several phase III programmes with cholesteryl ester transfer protein (CETP) inhibitors. OBJECTIVES: To assess alternative methods to predict clinical response of CETP inhibitors. METHODS: Meta-regression analysis on raising HDL-C drugs (statins, fibrates, niacin) in randomised controlled trials...
June 2015: Heart: Official Journal of the British Cardiac Society
Matteo Mozzicafreddo, Massimiliano Cuccioloni, Laura Bonfili, Valentina Cecarini, Francesco Alessandro Palermo, Paolo Cocci, Gilberto Mosconi, Aida Capone, Irene Ricci, Anna Maria Eleuteri, Mauro Angeletti
Liver X receptor is a ligand-activated transcription factor, which is mainly involved in cholesterol homeostasis, bile acid and triglycerides metabolism, and, as recently discovered, in the glucose metabolism by direct regulation of liver glucokinase. Its modulation by exogenous factors, such as drugs, industrial by-products, and chemicals is documented. Owing to the abundance of these synthetic molecules in the environment, and to the established target role of this receptor, a number of representative compounds of phthalate, organophosphate and fibrate classes were tested as ligands/modulators of human liver X receptor, using an integrated approach, combining an in silico molecular docking technique with an optical SPR biosensor binding study...
August 2015: Journal of Steroid Biochemistry and Molecular Biology
Rajagopal V Sekhar
Patients infected with HIV have a high risk of developing dyslipidemia. Effective therapeutic strategies can be challenging due to an increase risk of drug interactions and other comorbidities. Understanding the underlying pathophysiology and the principles of pharmacological and non-pharmacological therapeutic interventions can be of value in the appropriate management of dyslipidemia in the HIV-infected patient.
April 2015: Current Atherosclerosis Reports
Laura Flink, James A Underberg, Jonathan D Newman, Eugenia Gianos
The National Lipid Association (NLA) recently released recommendations for the treatment of dyslipidemias. These recommendations have commonalities and differences with those of other major societies with respect to risk assessment, lifestyle therapy, targets of therapy, and the use of non-statin agents. In this review, we compare the basic elements of the guidelines from each major society to provide clinicians with a comprehensive document reviewing the key principles of each.
April 2015: Current Atherosclerosis Reports
Nisanne S Ghonem, David N Assis, James L Boyer
Cholestasis, including primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC), results from an impairment or disruption of bile production and causes intracellular retention of toxic bile constituents, including bile salts. If left untreated, cholestasis leads to liver fibrosis and cirrhosis, which eventually results in liver failure and the need for liver transplantation. Currently, the only therapeutic option available for these patients is ursodeoxycholic acid (UDCA), which slows the progression of PBC, particularly in stage I and II of the disease...
August 2015: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Don P Wilson, Catherine McNeal, Piers Blackett
During the last 50 years, it has become evident that atherosclerosis originates in childhood. Although cardiovascular disease (CVD) events are rare in children, autopsy data and imaging studies have documented subclinical disease in association with measurable risk factors during childhood. When present at a young age, risk factors track into adulthood and have been associated with a moderate to high risk of future CVD. As such, the ability to identify this vulnerable population creates the opportunity to prevent the development of risk factors and future CVD events with effective management of genetic and acquired risk factors...
January 2015: Southern Medical Journal
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