Via practica 11/2009

The role of fibrates in a statin world

Fibrates began to be used in our clinical practice 40 years ago. Clofibrate was the first agent to be tested in clinical trials designed to evaluate the effect of lowering cholesterol levels on cardiac outcomes. One of these trials showed an excess risk all cause mortality in treating group and clofibrate has since been removed from the market. Fibrates rebounded with the publication of Helsinki Heart Study. At this time first statin – lovastatin became available and started the era of large statin trials. Recently there has been resurgence of interest in fibrates for several reasons (results from VA-HIT study, discovery, that fibrates are ligands for PPAR-α, growing data about residual cardiovascular risk).

Keywords: fibrates, PPAR-α, FIELD, ACCORD, SAFARI trial