A review of paradoxical HDL-C responses to fenofibrate, illustrated by a case report

Abstract High-density lipoprotein cholesterol (HDL-C) concentration is an independent risk factor for cardiovascular disease. Fibrates are widely used in the management of atherogenic dyslipidemia, principally for their triglyceride-lowering and HDL-C–raising effects. Fibrates may cause paradoxical...

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Bibliographic Details
Published in:Journal of clinical lipidology 2014-07, Vol.8 (4), p.455-459
Main Authors: Schofield, Jonathan D., BSc, MRCP, Liu, Yifen, BSc, France, Michael W., MSc, FRCPath, Sandle, Lance, BSc, FRCPath, Soran, Handrean, MSc, MD, FRCP
Format: Article
Language:English
Subjects:
Amlodipine - administration & dosage
Atorvastatin Calcium
Cardiovascular
Cholesterol, HDL - metabolism
Drug Interactions
Dyslipidemias - drug therapy
Female
Fenofibrate
Fenofibrate - administration & dosage
Fenofibrate - adverse effects
HDL
Heptanoic Acids - administration & dosage
High-density lipoprotein
High-density lipoprotein cholesterol
Humans
Lansoprazole - administration & dosage
Lipid Metabolism - drug effects
Middle Aged
Nitrofurantoin - administration & dosage
Paradoxical reduction in high-density lipoprotein cholesterol
Pyrroles - administration & dosage
Treatment Outcome
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Summary:Abstract High-density lipoprotein cholesterol (HDL-C) concentration is an independent risk factor for cardiovascular disease. Fibrates are widely used in the management of atherogenic dyslipidemia, principally for their triglyceride-lowering and HDL-C–raising effects. Fibrates may cause paradoxical reductions in HDL-C. These reductions are usually modest, but significant reductions have been observed. The molecular mechanism for these paradoxical reductions remains unexplained despite advances in our understanding of lipid metabolism. This review considers possible mechanisms for this effect, illustrated by a patient with an observed reduction in HDL-C of 88% after introduction of fenofibrate.
ISSN:1933-2874
1876-4789
DOI:10.1016/j.jacl.2014.05.003