Abstract
Introduction: Patients with mixed dyslipidemia are presented with high levels of low-density lipid cholesterol (LDL-C), triglycerides (TG), and reduced high-density lipid cholesterol (HDL-C). Though useful in lowering LDL-C, therapy with rosuvastatin is insufficient in optimizing the overall lipid profile, thus putting the patient at risk of residual cardiovascular risk. A combination of statin with other lipid-modifying agents has been used with more efficient lipid control and cardiovascular risk prevention. Of these, fenofibric acid is the most frequently used, along with rosuvastatin.
 Methods: Authors conducted a literature search of published literature to assess the use of rosuvastatin and fenofibrate combination in the management of mixed hyperlipidaemia.
 Results and discussion: The authors selected a total of 46 articles to be included in the review. Due to the small number of articles and heterogeneity on the combination of rosuvastatin and fenofibrate combination in mixed hyperlipidemia, the findings herein are presented using narrative summaries. Based on the thorough assessment of the selected literature, the essential themes that emerged from the review include safety and efficacy of rosuvastatin and fenofibrate combination, place of therapy of rosuvastatin, and fenofibrate combination, and potential cardiovascular risk reduction with rosuvastatin and fenofibrate combination. 
 Conclusion: Based on the review, the authors suggested that the combination therapy with fenofibric acid was beneficial, well-tolerated with a similar safety profile compared with statin monotherapy. The combination therapy of moderate dose rosuvastatin and fenofibric acid led to a reduction of cardiovascular risk factors via several pathways.
Highlights
Patients with mixed dyslipidemia are presented with high levels of low-density lipid cholesterol (LDL-C), triglycerides (TG), and reduced high-density lipid cholesterol (HDL-C)
The study findings showed that coadministration of rosuvastatin and fenofibrate produced minimal changes in rosuvastatin and fenofibric acid exposure about a minor increase in the AUC from 0 to 24 hours and Cmax of rosuvastatin; the respective geometric least-square means increased by 7% and 21%
Rosuvastatin -fenofibric acid fixed-dose combinations have significantly improved triglycerides, HDL-C, nonHDL-C, apolipoprotein B, and high sensitivity Creactive protein levels compared with simvastatin monotherapy (P≤.04 for all comparisons) [14]
Summary
The management of coronary heart disease has transformed with statin therapy as the reduction of low-density lipoprotein cholesterol (LDL-C) is an essential factor. It becomes imperative to strategically use aggressive lipid-altering therapy to manage cardiovascular risk profiles in individuals with mixed dyslipidemia. In such cases, monotherapy, often with statins, is unable to achieve the targeted optimisation of increased LDL-C and TG levels along with the low levels of HDL-C. Monotherapy, often with statins, is unable to achieve the targeted optimisation of increased LDL-C and TG levels along with the low levels of HDL-C In such a situation, the use of combination therapy becomes imperative [6]. The authors have attempted to throw insight on the place of therapy of rosuvastatin and fenofibrate combination therapy versus statin monotherapy, the safety profile of the combination, and its potential role in reducing the cardiovascular risk in patients of mixed dyslipidemia
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