Determinants of bezafibrate-induced improvements in LDL cholesterol in dyslipidemic patients with diabetes: A subgroup analysis of the J-BENEFIT study

Aim: our previous j-benefit (japan bezafibrate clinical effectiveness and tolerability) study demonstrated that bezafibrate improves blood lipid profiles and glucose control in dyslipidemic patients with diabetes. however,bezafibrate did not significantly improve low-density lipoprotein cholesterol (ldl-c),although some patients showed decreases while others showed increases in the ldl-c levels. therefore,a subgroup analysis of the j-benefit study was conducted to identify factors influencing the bezafibrate-induced changes in the ldl-c levels. methods: of the 3,316 patients in the j-benefit study,2,116 not treated with other lipid-lowering drugs were enrolled in the current study,and the effects of 24-week treatment with bezafibrate on the ldl-c levels were analyzed. a reduction in the ldl-c level of > 25% occurred in 253 patients,and a logistic-regression analysis was used to identify factors associated with this improvement. results: among the 2,116 overall patients,bezafibrate treatment significantly increased the ldl-c levels from 123.9 ± 36.7 to 125.7± 31.3 mg/dl. the subanalysis showed that the treatment responses varied according to the baseline ldl-c level,with significant decreases in the > 160 and > 140-< 160 mg/dl groups,no significant decrease in the > 120-< 140 mg/dl group and a significant increase in the < 120 mg/dl group. a multivariate logistic-regression analysis of the data for the patients with an ldl-c of > 25% identified a female sex,the use of anti-hypertensive and hypoglycemic agents and a high baseline ldl-c level to be significant determinants of the ldl-c response to bezafibrate. conclusions: our results showed that treatment with bezafibrate improves the ldl-c levels and lipid profiles in dyslipidemic diabetic patients,especially women,subjects co-treated with anti-hypertensive or hypoglycemic agents and those with high baseline ldl-c levels. © 2015,japan atherosclerosis society. all rights reserved.