Fibrates: no ACCORD on their use in the treatment of dyslipidaemia

Current Opinion in Lipidology
Anthony S Wierzbicki

Abstract

New data have emerged over the last few years about the role of fibrates in treatment of microvascular and macrovascular disease. Endpoint studies have been conducted with fibrates in coronary heart disease since 1971 and results have been contradictory. Fibrates have shown benefits in patients with low HDL-cholesterol and low LDL-cholesterol. Fibrates remain topical, given their actions on the lipid triad present in the metabolic syndrome and in diabetes. In the Fenofibrate Intervention in Endpoint Lowering in Diabetes study of mixed primary and secondary prevention cohorts, fenofibrate therapy resulted in an 11% reduction in coronary or cardiovascular events in monotherapy. Despite frequent use, there was little endpoint data on fibrate-statin combination therapy until recently. The Action to Control Cardiovascular Risk in Diabetes trial of fenofibrate added to baseline simvastatin therapy in diabetes showed a nonsignificant 8% reduction in cardiovascular events. The benefits were concentrated in men, and women did slightly worse with fibrate therapy. In post-hoc analysis, slight beneficial effects of fenofibrate were seen in patients with moderate hypertriglyceridaemia (>2.3 mmol/l) and low HDL-cholesterol (<0.88 mmol/l). Th...Continue Reading

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Citations

Dec 16, 2010·International Journal of Clinical Practice·A S Wierzbicki
Mar 16, 2011·International Journal of Clinical Practice·A S Wierzbicki
Oct 15, 2011·International Journal of Clinical Practice·Anthony S Wierzbicki
Feb 22, 2012·International Journal of Clinical Practice·A S WierzbickiA Viljoen
Jul 3, 2013·Current Cardiology Reports·James BarnettAnthony S Wierzbicki
Aug 2, 2011·Expert Opinion on Therapeutic Targets·Ronald Pj Oude Elferink, Ulrich Beuers
Oct 17, 2014·Expert Opinion on Pharmacotherapy·Anthony S Wierzbicki, Adie Viljoen
Apr 13, 2012·Expert Opinion on Investigational Drugs·Anthony S WierzbickiAdie Viljoen
Mar 26, 2013·International Journal of Clinical Practice·A S Wierzbicki
Jun 14, 2013·International Journal of Clinical Practice·A S Wierzbicki
Apr 12, 2013·International Journal of Clinical Practice·Anthony S Wierzbicki
Apr 9, 2016·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Jonathan D SchofieldHandrean Soran
Dec 4, 2014·Clinical Medicine : Journal of the Royal College of Physicians of London·Anthony S WierzbickiMfon Ewang-Emukowhate
Nov 16, 2010·PPAR Research·Ching-Feng ChengHeng Lin
Nov 17, 2016·The Cochrane Database of Systematic Reviews·Tobias JakobMatthias Briel
May 9, 2012·Current Opinion in Cardiology·Anthony S WierzbickiDimitri P Mikhailidis
Mar 18, 2020·Pharmacogenomics·John S House, Alison A Motsinger-Reif
May 24, 2016·Current Opinion in Lipidology·Handrean SoranPaul N Durrington
Apr 27, 2011·Current Opinion in Lipidology·Sandeep A Saha, Rohit R Arora
Apr 7, 2011·Angiology·Sanja S SoskićEsma R Isenović

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