Fenofibric acid plus statin combination therapy for the treatment of mixed dyslipidemia

Patients with mixed dyslipidemia have a higher risk of atherosclerotic coronary heart disease than patients with isolated elevated LDL-C. Evidence-based guidelines target LDL-C reduction and other lifestyle factors to reduce risk. However, patients with mixed dyslipidemia have a high risk of vascular events, even with statin treatment to optimal LDL-C levels. Available treatments for other modifiable lipid factors, such as elevated triglycerides and reduced HDL-C, are underutilized in such patients since there are no large-scale clinical outcomes trials showing incremental benefit, as well as clinician concerns regarding safety with combination treatment. Recent efficacy and safety trials have demonstrated that the combination of fenofibric acid and a statin improves multiple lipid parameters in patients with mixed dyslipidemia without additional safety concerns compared with the individual monotherapies. Ongoing surrogate and event outcomes trials are testing the incremental benefit of such a combination treatment strategy.