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Efficacy and safety profile of fenofibrate-coated microgranules 130 mg, with and without food, in patients with hypertriglyceridemia and the metabolic syndrome: an 8-week, randomized, double-blind, placebo-controlled study.

AbstractBACKGROUND:
The limited bioavailability of certain fenofibrate formulations necessitates administration with food, raising concerns about efficacy and compliance. There is a need for new formulations that have improved bioavailability and eliminate the requirement for administration with food.
OBJECTIVE:
The aim of this study was to assess the food-related efficacy of a new formulation of micronized fenofibrate coated on inert microgranules (FF-muG) for the treatment of hypertriglyceridemia in patients exhibiting the metabolic syndrome.
METHODS:
This was a randomized, double-blind, placebo-controlled, double-dummy, parallel-group study in patients who had fasting triglyceride (TG) concentrations > or =300 mg/dL and <1000 mg/dL and met National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome. A 6-week washout and diet lead-in period was followed by an 8-week treatment period. Eligible patients were randomized to receive either FF-muG 130 mg with food, FF-muG 130 mg without food, or placebo every day for 8 weeks. The primary end point was the mean percent change in TG levels from baseline to the end of treatment; changes in other lipid end points were also assessed. Safety profiles were assessed based on adverse-event reports, changes in clinical laboratory values and vital signs (including electrocardiography), and the findings of physical examinations.
RESULTS:
One hundred forty-six patients took part in the study: 54 received FF-muG 130 mg with food, 42 received FF-muG 130 mg without food, and 50 received placebo. The groups were similar in terms of mean age (56 years), sex (59.5%-63.0% men; 37.0%-40.5% women), race (83.3%-100% white), mean body weight (92 kg), mean height (172 cm), mean fasting baseline TG concentrations (480 mg/dL), and other components of the metabolic syndrome. The 2 FF-muG groups (with and without food) showed similar improvements in the dyslipidemia associated with the metabolic syndrome: TG levels decreased a mean of 36.7% and 36.6%, respectively (P < 0.001 vs placebo). The overall frequency of adverse events was similar in the 2 FF-muG groups and did not differ significantly from placebo (63.0%, 61.9%, and 52.0%, respectively). Gastrointestinal disturbances (eg, diarrhea, dyspepsia) occurred more frequently in the 2 FF-muG groups compared with the placebo group (31.5%, 26.2%, and 12.0%; P = NS). Significant increases from baseline in alanine aminotransferase were seen in both FF-muG groups (mean [SEM], 3.77 [2.60] and 11.69 [7.42] U/L, respectively; P < or = 0.05 vs placebo); however, these increases were considered clinically significant in only 5 cases, none of them requiring discontinuation of study drug.
CONCLUSIONS:
This study found no inequivalence in the TG-lowering effects of the 2 fenofibrate regimens compared with placebo. Both regimens were well tolerated. Thus, FF-muG 130 mg administered without regard to meals appears to be efficacious and well tolerated for the treatment of hypertriglyceridemia in patients exhibiting the metabolic syndrome.
AuthorsMichael H Davidson, Harold Bays, James Rhyne, Evan Stein, Keith Rotenberg, Ralph Doyle
JournalClinical therapeutics (Clin Ther) Vol. 27 Issue 6 Pg. 715-27 (Jun 2005) ISSN: 0149-2918 [Print] United States
PMID16117978 (Publication Type: Journal Article, Randomized Controlled Trial)
Chemical References
  • Capsules
  • Cholesterol, HDL
  • Cholesterol, VLDL
  • Hypolipidemic Agents
  • Triglycerides
  • Fenofibrate
Topics
  • Capsules
  • Cholesterol, HDL (blood)
  • Cholesterol, VLDL (blood)
  • Diarrhea (chemically induced)
  • Double-Blind Method
  • Drug Administration Schedule
  • Eating
  • Fasting
  • Female
  • Fenofibrate (adverse effects, therapeutic use)
  • Humans
  • Hypertriglyceridemia (blood, complications, drug therapy)
  • Hypolipidemic Agents (adverse effects, therapeutic use)
  • Male
  • Metabolic Syndrome (blood, complications, drug therapy)
  • Middle Aged
  • Nausea (chemically induced)
  • Reference Values
  • Treatment Outcome
  • Triglycerides (blood)

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