Liver Ultrasound for Patient with Reduced Triglycerides After Fenofibrate

Monitoring and Treatment Guidelines

• The American College of Cardiology recommends evaluating liver function before starting fenofibrate, within 3 months after initiation, and every 6 months thereafter 1
• Current guidelines recommend monitoring liver function tests rather than imaging for patients on fenofibrate therapy 1
• Liver ultrasound would be indicated if there were significant elevations in liver enzymes (ALT >5 times upper limit of normal) 2, 3
• For a patient with initial triglycerides of 900 mg/dL now reduced to 230 mg/dL, the patient has demonstrated excellent response to therapy, reducing risk of pancreatitis 4
• The American College of Cardiology suggests that focus should be on continued monitoring of lipid levels and liver function tests rather than imaging, with consideration of additional lifestyle modifications to further reduce triglyceride levels to <150 mg/dL 1, 4