Effect of Fibrate-Statin Combination Therapy on Lipid Profiles in Patients with Type 2 Diabetes: A Systematic Review and Meta-Analysis

This meta-analysis evaluates the efficacy of combining statins with fibrates for improving lipid profiles in patients with Type 2 Diabetes Mellitus (T2DM). While statin monotherapy is known to effectively modify lipid parameters in T2DM, recent evidence suggests that combination therapy may offer additional benefits in managing lipid levels and reducing cardiovascular risks. A systematic review of randomized clinical trials (RCTs) comparing statin monotherapy to statin-fibrate combination therapy was conducted. Data were sourced from PubMed and Embase, and studies published up to October 2023 were included. A total of 7 RCTs with 1,349 participants met the inclusion criteria. Of these, 676 participants (50%) received combination therapy, with follow-up durations ranging from 3 to 56.4 months. Results showed that combination therapy led to significant reductions in total cholesterol (TC) (-8.65 mg/dL), low-density lipoprotein cholesterol (LDL-C) (-5.52 mg/dL), and triglycerides (TG) (-53.59 mg/dL). Additionally, high-density lipoprotein cholesterol (HDL-C) levels were significantly higher in the combination therapy group (+ 2.33 mg/dL). The findings suggest that combining statins with fibrates significantly improves lipid parameters in T2DM patients. However, the high heterogeneity among studies indicates the need for further controlled trials to better assess the cardiovascular benefits of this combination therapy and provide more definitive conclusions.