Drugs that affect lipid metabolism

Publisher Summary This chapter presents the studies of the effects of drugs that affect lipid metabolism. Serious myopathy has been studied in a systematic review of PubMed listed studies of ezetimibe alone or combined with a statin. The frequency of musculoskeletal disorders was found to be identical with placebo or, in the case of combination therapy, with the frequency associated with the statin. These reports relate to serious events defined as “myopathies” and not to the occurrence of myalgia in which no objective measure of muscle damage is demonstrable. Three clinical laboratory abnormalities that have been initially documented in the FIELD study—namely, raised concentrations of homocysteine and creatinine and increased albuminuria—have been confirmed in smaller studies. The importance of these potentially serious adverse findings is uncertain. The major concern about myopathy when fibrates are combined with statins, as in the cerivastatin + gemfibrozil disaster, has largely abated. Several large analyses have not shown an increased risk of serious adverse events when feno fibrate was co-administered with a statin.