Pharmacotherapy of Mixed Hyperlipidemia with Ezetimibe-Fenofibrate Combination Therapy

Mixed hyperlipidemia is a frequent atherogenic dyslipidemia characterized by elevated triglycerides, low HDL cholesterol levels, and excess of small, dense LDL particles, often with elevated apolipoproteinB and non-HDL cholesterol concentrations. Although statins are the drug of first choice, many high-risk patients with mixed hyperlipidemia do not achieve the recommended goals with statin monotherapy. Due to the complementary effects of ezetimibe and fenofibrate on the components of atherogenic dyslipidemia, the combination of these two drugs is an alternative treatment option for patients with mixed hyperlipidemia. However, the potential benefit of ezetimibe-fenofibrate combination therapy in cardiovascular risk reduction strategies remains to be established and this combination therapy should only be considered as a second-line therapy and appears to be particularly useful for patients with a poor response or an intolerance to statin monotherapy.