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Effect of ciprofibrate on C-reactive protein and fibrinogen levels
Evagelos Rizos1, Angeliki Kostoula, Moses Elisaf
1Department of Internal Medicine, Medical School, University of Ioannina, Greece.
Insights
Ciprofibrate significantly reduced C-reactive protein (CRP) and fibrinogen levels in patients with dyslipidemia. This suggests fibrates, like statins, lower vascular risk markers through distinct mechanisms.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- C-reactive protein (CRP) is a marker of vascular risk.
- Statins are known to reduce CRP levels.
- Evidence for fibrates reducing CRP is limited.
Purpose of the Study:
- To investigate the effect of ciprofibrate on CRP levels.
- To examine the impact of ciprofibrate on plasma fibrinogen.
- To compare the effects of fibrates and statins on these markers.
Main Methods:
- A study involving 30 patients with primary dyslipidemia.
- Treatment with ciprofibrate (100 mg once daily) for 8 weeks.
- Measurement of CRP and fibrinogen levels before and after treatment.
Main Results:
- Significant reduction in median CRP levels by 36.8% (p < 0.01).
- Significant reduction in plasma fibrinogen levels (p = 0.05).
- No correlation found between CRP reduction and changes in lipids or fibrinogen.
Conclusions:
- Ciprofibrate effectively lowers serum CRP levels, similar to statins.
- Fibrates also reduce plasma fibrinogen, a distinct effect from statins.
- These findings may elucidate mechanisms of drug-induced changes in CRP and fibrinogen, potentially enhancing clinical efficacy.
Abstract:
Statins can lower the circulating levels of C reactive protein (CRP). This effect may be relevant because CRP is a predictor of vascular risk. In contrast, the evidence that fibrates lower CRP levels is very limited. The effect of treatment with ciprofibrate (100 mg once daily) was investigated for 8 weeks in 30 patients with primary dyslipidemia. There was a significant (p < 0.01) decrease in median (range) CRP levels by 36.8% from 1.9 mg/L (1.0-6.0 mg/L) to 1.2 mg/L (1.0-5.5 mg/L). Plasma fibrinogen levels were also significantly (p = 0.05) reduced. There was no correlation between the fall in CRP levels and the changes in lipid or fibrinogen levels. These findings support the concept that fibrates, like the statins, lower serum CRP levels. However, fibrates have a different mode of action. Fibrates (with the exception of gemfibrozil) also consistently lower plasma fibrinogen levels. In contrast, the effect of statins on the circulating levels of this coagulation factor remains to be defined. These differences may help in defining the mechanisms responsible for drug-induced changes in the circulating levels of CRP and fibrinogen. A favorable effect on CRP and fibrinogen levels may increase the clinical efficacy of statins and fibrates.