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Homocysteine elevation with fibrates: is it a class effect?

D Harats¹, O Yodfat, R Doolman

¹Institute of Lipid and Atherosclerosis Research, Sheba Medical Center, Tel-Hashomer, Israel. dharats@post.tau.ac.il

The Israel Medical Association Journal : IMAJ

|May 10, 2001

Summary

Ciprofibrate significantly increases plasma homocysteine levels, while bezafibrate reduces them. This homocysteine elevation is reversible after stopping ciprofibrate treatment, indicating it

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Area of Science:

Pharmacology and Cardiovascular Medicine
Lipid Metabolism and Atherosclerosis Research

Background:

Elevated plasma homocysteine is a significant risk factor for atherosclerotic vascular diseases.
Certain medications, including some lipid-lowering drugs, can influence homocysteine levels.
Previous studies suggest interactions between fibrates and homocysteine plasma levels.

Purpose of the Study:

To investigate the impact of different fibrate medications on plasma homocysteine levels.
To assess the reversibility of observed changes in homocysteine following fibrate treatment cessation.

Main Methods:

Evaluated ciprofibrate and bezafibrate effects on homocysteine in hyperlipidemia patients.
Measured homocysteine levels during 12 weeks of treatment and after a 6-week cessation period.

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Main Results:

Ciprofibrate treatment led to a 57% increase in plasma homocysteine levels.
Bezafibrate treatment resulted in a 17% reduction in plasma homocysteine levels.
The homocysteine increase with ciprofibrate was sustained and partially reversible post-treatment.

Conclusions:

Fibrates do not uniformly affect homocysteine levels; the magnitude of change varies by drug.
The observed increase in plasma homocysteine with ciprofibrate is reversible upon drug discontinuation.