Related Experiment Video
Updated: Dec 22, 2025
Network Pharmacology Prediction and Metabolomics Validation of the Mechanism of Fructus Phyllanthi against Hyperlipidemia
Published on: April 7, 2023
EFFICACY OF INSULIN, HEPARIN AND FENOFIBRATE COMBINATION TREATMENT IN SEVERE HYPERTRIGLYCERIDEMIA: DOUBLE CENTER
S Ozcelik1, S Baş2, M Ozcelik3
1Adıyaman University Training and Research Hospital - Department of Endocrinology and Metabolism, Istanbul, Turkey.
Insights
This study found that a combination therapy of insulin, heparin, and fenofibrate is a safe and effective treatment for severe hypertriglyceridemia (SH). The treatment significantly reduced triglyceride levels without observed toxicities.
Area of Science:
- Endocrinology
- Cardiovascular Medicine
- Pharmacology
Background:
- Severe hypertriglyceridemia (SH), defined as triglyceride (TG) levels >1000 mg/dL, presents a significant health challenge.
- Existing treatment options for SH have limitations, and the safety and efficacy of combination therapies require further investigation due to small study sizes.
Purpose of the Study:
- To evaluate the efficacy and safety of a combination therapy involving heparin, insulin, and fenofibrate for treating patients diagnosed with severe hypertriglyceridemia.
Main Methods:
- The study included 42 adult patients with TG levels >1000 mg/dL and adequate organ function.
- Triglyceride levels were monitored on days 0, 3, and 6. Treatment dosage, duration, response, and adverse events were assessed.
- Patients presenting with acute pancreatitis received additional lipid apheresis.
Main Results:
- The combination therapy led to a significant reduction in median TG levels from 2141.0 mg/dL at baseline to 921 mg/dL on day 3 and 437 mg/dL on day 6 (p<0.0001).
- No significant toxicities, such as hypoglycemia, hemorrhage, elevated creatine kinase, or hepato-/nephrotoxicity, were observed.
- The majority of patients (85.8%) had secondary causes of hypertriglyceridemia, and 14.3% presented with acute pancreatitis.
Conclusions:
- The combination of insulin, heparin, and fenofibrate demonstrated to be a safe and effective therapeutic strategy for managing severe hypertriglyceridemia.
- This approach offers a promising treatment option for patients with severe hypertriglyceridemia, including those with acute pancreatitis when combined with lipid apheresis.
Context:
Severe hypertriglyceridemia (SH), which calls for a triglyceride (TG) level above 1000 mg/dL, remains an important health issue. While some data exist to offer combination of heparin, insulin and fenofibrate as a reasonable treatment option, safety and benefits of this therapy have not been accurately weighted, largely due to the limited sample size of the relevant studies.
Aim:
Assess the efficacy and safety of the heparin, insulin and fenofibrate combination in the treatment of patients with SH.
Patients - Methods:
Patients aged ≥18 years with TG level above 1000 mg/dL and adequate organ function were included. Triglyceride levels were measured immediately before the treatment and on the 3rd and 6th days of the treatment. Treatment dosage, duration, response and side effects were assessed. Patients with hypertriglyceridemia presenting with acute pancreatitis were treated additionally with lipid apheresis.
Results:
A total of 42 patients were included. Of these, 85.8% came to medical attention with some kind of secondary hypertriglyceridemia causes. The baseline median TG value of the cases was 2141.0 mg/ dL (1026-12250). There were 6 patients (14.3%) with acute pancreatitis at presentation. In patients without pancreatitis, with administration of insulin infusion, unfractionated heparin infusion and fenofibrate capsule, median TG values decreased to 921 mg/ dL (190-6400) on the 3rd day and to 437 mg/ dL (112-1950) on the 6th day of the treatment (p<0.0001, Friedman test). Potential toxicities related to insulin, heparin and fenofibrate combination treatment including hypoglycemia, hemorrhage, rise in creatine kinase levels, hepato - and nephrotoxicity were not observed.
Conclusion:
In this trial involving patients with SH, our data suggest that insulin, heparin and fenofibrate combination therapy was safe and effective.
Related Concept Videos
01:23Dipeptidyl Peptidase 4 Inhibitors
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:15Diabetes: Management and Pharmacotherapy
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
01:16Insulin: Dosing Regimen and Adverse Effects
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
01:29Venous Thrombosis III: Interprofessional Care