Colesevelam/fenofibrate combination boosts efficacy in treatment of hyperlipidemia. Fenofibrate significantly reduced low-density lipoprotein cholesterol (LDL-C) in patients with mixed hyperlipidemia when used in combination with the specifically engineered bile acid sequestrant (SE-BAS) colesevelam, according to a study published in Current Medical Research and Opinion.

Compared with fenofibrate monotherapy, the fenofibrate/colesevelam mix also significantly reduced mean non-high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC), and apolipoprotein B (apo B) levels without significantly affecting the triglyceride (TG)-lowering or HDL-C-raising effects of fenofibrate.

"These results have important implications for the management of patients with mixed hyperlipidemia," the authors stated. They noted the recommendation of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) that a second treatment goal, as defined by non-HDL-C levels, be utilized for patients who had achieved their LDL-C treatment goal but still displayed TG levels of greater than 200 mg/dL.

After 6 weeks of treatment, fenofibrate plus colesevelam produced a mean change of –10.4% in LDL-C, the primary efficacy end point. Fenofibrate monotherapy resulted in a change of +2.3% (P<.0001). Fenofibrate plus colesevelam was significantly more effective than fenofibrate alone at reducing levels of secondary end points non-HDL-C (9.6% difference), TC (7.4%), and apo B (8%) (P≤.0002).

No significant changes were recorded in the levels of other secondary end points, including HDL-C, TG, and apo A-1.

Both treatment regimens were safe and well-tolerated.

McKenney J, Jones M, Abby S. Safety and efficacy of colesevelam hydrochloride in combination with fenofibrate for the treatment of mixed hyperlipidemia. Curr Med Res Opin. 2005; 21:1403–1412.