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Statin dose reduction with complementary diet therapy: A pilot study of personalized medicine.
Scolaro, Bianca; Nogueira, Marina S; Paiva, Aline; Bertolami, Adriana; Barroso, Lucia P; Vaisar, Tomas; Heffron, Sean P; Fisher, Edward A; Castro, Inar A.
Afiliação
  • Scolaro B; Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Lineu Prestes, 580, B14 - 05508-900, São Paulo, Brazil.
  • Nogueira MS; Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Lineu Prestes, 580, B14 - 05508-900, São Paulo, Brazil.
  • Paiva A; Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Lineu Prestes, 580, B14 - 05508-900, São Paulo, Brazil.
  • Bertolami A; Dyslipidemia Medical Section, Dante Pazzanese Institute of Cardiology, Av. Dr. Dante Pazzanese, 500, 04012-909, São Paulo, Brazil.
  • Barroso LP; Department of Statistics, Institute of Mathematics and Statistics, University of São Paulo, Rua do Matão, 1010, 05508-090, São Paulo, Brazil.
  • Vaisar T; Department of Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA.
  • Heffron SP; Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
  • Fisher EA; Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY 10016, USA.
  • Castro IA; Department of Food and Experimental Nutrition, Faculty of Pharmaceutical Sciences, University of São Paulo, Av. Lineu Prestes, 580, B14 - 05508-900, São Paulo, Brazil. Electronic address: inar@usp.br.
Mol Metab ; 11: 137-144, 2018 05.
Article em En | MEDLINE | ID: mdl-29503145
OBJECTIVE: Statin intolerance, whether real or perceived, is a growing issue in clinical practice. Our aim was to evaluate the effects of reduced-dose statin therapy complemented with nutraceuticals. METHODS: First phase: Initially, 53 type 2 diabetic statin-treated patients received a supplementation with fish oil (1.7 g EPA + DHA/day), chocolate containing plant sterols (2.2 g/day), and green tea (two sachets/day) for 6 weeks. Second phase: "Good responders" to supplementation were identified after multivariate analysis (n = 10), and recruited for a pilot protocol of statin dose reduction. "Good responders" were then provided with supplementation for 12 weeks: standard statin therapy was kept during the first 6 weeks and reduced by 50% from weeks 6-12. RESULTS: First phase: After 6 weeks of supplementation, plasma LDL-C (-13.7% ± 3.7, P = .002) and C-reactive protein (-35.5% ± 5.9, P = .03) were reduced. Analysis of lathosterol and campesterol in plasma suggested that intensity of LDL-C reduction was influenced by cholesterol absorption rate rather than its synthesis. Second phase: no difference was observed for plasma lipids, inflammation, cholesterol efflux capacity, or HDL particles after statin dose reduction when compared to standard therapy. CONCLUSIONS: Although limited by the small sample size, our study demonstrates the potential for a new therapeutic approach combining lower statin dose and specific dietary compounds. Further studies should elucidate "good responders" profile as a tool for personalized medicine. This may be particularly helpful in the many patients with or at risk for CVD who cannot tolerate high dose statin therapy. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02732223.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores de Hidroximetilglutaril-CoA Redutases / Dietoterapia / Medicina de Precisão Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Mol Metab Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Inibidores de Hidroximetilglutaril-CoA Redutases / Dietoterapia / Medicina de Precisão Tipo de estudo: Clinical_trials / Guideline / Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Revista: Mol Metab Ano de publicação: 2018 Tipo de documento: Article País de afiliação: Brasil País de publicação: Alemanha