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Q: What drugs can be used to lower inflammation (c-reactive protein) levels besides statins?
My mom has elevated LDL cholesterol and c-reactive protein levels. She is unable to take statin drugs, due to the muscle damage problem. She tried niacin, and couldn’t tolerate that. She is currently taking Zetia, but it seems that current research is showing that zetia will reduce cholesterol all right, but does nothing to lower heart attack risk, probably because inflammation is the main issue there.
I did a little research and found out some stuff about bile acid resins and fibrates, drugs I’ve never heard of. It would be nice for her to know what some other options are when she talks to the doctor next. We’re trying to figure out what drug options we want to keep open while picking out her next year’s medicare drug plan (see which formularies offer the most options for this problem). It’s hard to research this online, because everything pushes statins, which she can’t take.
She’s slim and eats right (low saturated fat) and exercises & is otherwise very healthy.
Thanks for sharing your experiences!
A: crp is an interesting biomarker for risk – but that is all it is! Latest research that just came out, called the Jupiter Trial, looked at folks with good LDL, excellent HDL ( over 50 ) and TG less than 100. They all had crp>2. Use of a statin lowered crp and there by lowered risk…..but, even the study designers do not know HOW risk was lowered – was it a direct effect of the drug or and indirect effect of the drug. Also – these folks ARE NOT representative of the current pop of folks seeking effective lipid management…..Not a study to be referenced in primary or specialty care – no real place.
What we do know in this field is #1 lower TC<200mg/dl. Then raise hld> 40 for a man and 50 for a woman. If TG are not below 150 – get then their.
Bile binding acids are good products – dosing is harder and they make you fart, alot. BUT – they are very very effective. Fibrates get the job done also and are relatively benign in side effect.
Again – CRP is interesting, but it is not currently a GOAL of therapy. The goals, even more specifically, are ldl<70mg/dl ( for high risk patients, non hld ( which is ldl goal+30 for the goal and to calc of your panel it is LDL+30) and then Apo B<80mg/dl
These are tough goals. good luck
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