Comparison of Bezafibrate and Simvastatin in the Treatment of Dyslipidaemia in Patients with NIDDM

✍ Scribed by Jeck, T.; Riesen, W.F.; Keller, U.

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 141 KB
• Volume: 14
• Category: Article
• ISSN: 0742-3071
• DOI: 10.1002/(sici)1096-9136(199707)14:7<564::aid-dia357>3.0.co;2-k

✦ Synopsis

Fibrates and HMG CoA reductase inhibitors are commonly used in the treatment of diabetic dyslipidaemia. However, these two groups of drugs have not been compared in diabetic patients in a randomized controlled trial. Therefore, a multicentre study was performed in 73 subjects with non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) and combined hyperlipidaemia (serum cholesterol 6.2-10.0 mmol l -1 , serum triglycerides 2.3-10.0 mmol l -1 ), comparing the efficacy of 400 mg bezafibrate with 10 mg simvastatin in a double-blind fashion. Treatment with bezafibrate during 12 weeks reduced serum triglycerides significantly more than simvastatin (-41 % vs -22 %, p Ͻ 0.001) and increased HDL cholesterol more (bezafibrate: + 17 % vs simvastatin: + 9 %, p Ͻ 0.05). LDL cholesterol levels decreased by 14 % (p Ͻ 0.001) during simvastatin and increased by 21 % (p Ͻ 0.01) during bezafibrate. This increase in LDL cholesterol was positively correlated with fasting serum triglycerides (p Ͻ 0.001) and was associated with a reduction of the serum apolipoprotein B concentration, suggesting an increase in LDL particle size. Metabolic control of diabetes (fasting glycaemia; HbA 1c ) and insulin secretion (C-peptide levels) were unaffected by both treatments. The incidence of side-effects during treatment was similar for both drugs. Thus, 400 mg bezafibrate mainly increases HDL cholesterol and lowers serum triglycerides but at the expense of an increase in LDL cholesterol; 10 mg simvastatin lowers LDL cholesterin more effectively but has a smaller effect on HDL cholesterol and triglycerides.