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Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis.

Publication ,  Journal Article
Sahebkar, A; Serban, M-C; Mikhailidis, DP; Toth, PP; Muntner, P; Ursoniu, S; Mosterou, S; Glasser, S; Martin, SS; Jones, SR; Rizzo, M; Rysz, J ...
Published in: Pharmacol Res
January 2016

BACKGROUND: Several studies suggest differences between fibrates and statins in lowering plasma fibrinogen (Fib) concentrations, but the evidence is not definitive. Therefore, the aim of this meta-analysis of head-to-head randomized trials was to compare the efficacy of statins and fibrates on plasma Fib concentrations. METHODS: The literature search included Medline, Scopus, and Web of Science up to February 1st, 2015, to identify head-to-head comparative randomized trials investigating the efficacy of fibrates vs statins on plasma Fib concentrations. RESULTS: In total 22 trials with 2762 participants were included to the meta-analysis. Random-effect meta-analysis suggested a significantly greater effect of fibrates vs statins in lowering plasma Fib concentrations (weighted mean difference [WMD]: -40.7mg/dL, 95% confidence interval [CI]: -55.2, -26.3, p<0.001). When the analysis was stratified according to the type of fibrate administered, there were significant Fib-lowering effects with both bezafibrate (n=8 treatment arms; WMD: -23.7mg/dL, 95% CI: -41.8, -5.7, p=0.01) and fenofibrate (n=15 treatment arms; WMD: -43.7mg/dL, 95% CI: -61.3, -26.2, p<0.001). Overall, there was a numerically greater effect in the subgroup of trials with ≥12 weeks duration (n=17 treatment arms; WMD: -42.7mg/dL, 95% CI: -60.3, -25.1, p<0.001) compared with the subgroup of trials lasting <12 weeks (n=7 treatment arms; WMD: -36.7mg/dL, 95% CI: -52.0, -21.4, p<0.001). CONCLUSIONS: Monotherapy with either fibrates or statins suggested a significantly greater effect of fibrates in lowering plasma Fib concentrations. According to these findings, mechanisms associated with fibrinogen metabolism might be responsible for the distinct effects of statins and fibrates in reducing cardiovascular endpoints.

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Published In

Pharmacol Res

DOI

EISSN

1096-1186

Publication Date

January 2016

Volume

103

Start / End Page

236 / 252

Location

Netherlands

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Pharmacology & Pharmacy
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Fibrinogen
  • Fibric Acids
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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Sahebkar, A., Serban, M.-C., Mikhailidis, D. P., Toth, P. P., Muntner, P., Ursoniu, S., … Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group, . (2016). Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis. Pharmacol Res, 103, 236–252. https://doi.org/10.1016/j.phrs.2015.12.001
Sahebkar, Amirhossein, Maria-Corina Serban, Dimitri P. Mikhailidis, Peter P. Toth, Paul Muntner, Sorin Ursoniu, Svetlana Mosterou, et al. “Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis.Pharmacol Res 103 (January 2016): 236–52. https://doi.org/10.1016/j.phrs.2015.12.001.
Sahebkar A, Serban M-C, Mikhailidis DP, Toth PP, Muntner P, Ursoniu S, et al. Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis. Pharmacol Res. 2016 Jan;103:236–52.
Sahebkar, Amirhossein, et al. “Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis.Pharmacol Res, vol. 103, Jan. 2016, pp. 236–52. Pubmed, doi:10.1016/j.phrs.2015.12.001.
Sahebkar A, Serban M-C, Mikhailidis DP, Toth PP, Muntner P, Ursoniu S, Mosterou S, Glasser S, Martin SS, Jones SR, Rizzo M, Rysz J, Sniderman AD, Pencina MJ, Banach M, Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group. Head-to-head comparison of statins versus fibrates in reducing plasma fibrinogen concentrations: A systematic review and meta-analysis. Pharmacol Res. 2016 Jan;103:236–252.
Journal cover image

Published In

Pharmacol Res

DOI

EISSN

1096-1186

Publication Date

January 2016

Volume

103

Start / End Page

236 / 252

Location

Netherlands

Related Subject Headings

  • Randomized Controlled Trials as Topic
  • Pharmacology & Pharmacy
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Humans
  • Fibrinogen
  • Fibric Acids
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences