Fenofibrate: metabolic and pleiotropic effects.
Disturbances of lipoprotein metabolism represent one of the most important risk factors for vascular events. However, dyslipidaemic patients often have a number of additional abnormalities (such as endothelial dysfunction, hypertension, low-grade inflammation, haemostatic abnormalities and hyperuricaemia) that may accelerate the atherosclerotic process. Thus, the ideal lipid-modifying drug, along with exerting beneficial effects on lipoprotein metabolism, should also improve these coexisting disturbances. Fibric acid derivatives (fibrates) are a class of lipid-modifying drugs mainly used in patients with elevated triglyceride levels. These drugs mainly exert their actions via the activation of specific nuclear receptors called peroxisome proliferator-activated receptors alpha (PPARalpha). In this review, we summarize the current evidence suggesting that fenofibrate, one of the most widely used fibric acid derivatives, along with its well established actions on lipids also exerts several other antiatherogenic actions. Based on recently published studies, fenofibrate is a useful option for patients with primary combined dyslipidaemias or secondary dyslipidaemias, such as those associated with diabetes mellitus, metabolic syndrome or HIV infection. Additionally, in cases of refractory dyslipidaemia, the combination of fenofibrate with statins is a therapeutic option.
Tsimihodimos
Vasilis
V
Department of Internal Medicine, Medical School, University of Ioannina, 451 10 Ioannina, Greece.
Miltiadous
George
G
Daskalopoulou
Stella S
SS
Mikhailidis
Dimitri P
DP
Elisaf
Moses S
MS
D000893:Anti-Inflammatory Agents / Q000378:metabolism / Q000494:pharmacology; D000933:Antifibrinolytic Agents / Q000378:metabolism / Q000494:pharmacology; D000975:Antioxidants / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use; D004730:Endothelium, Vascular / Q000187:drug effects; D011345:Fenofibrate / Q000378:metabolism* / Q000494:pharmacology / Q000627:therapeutic use*; D005343:Fibrinolytic Agents / Q000494:pharmacology; D006801:Humans; D047493:PPAR alpha / Q000187:drug effects / Q000378:metabolism / Q000627:therapeutic use; D011355:Prodrugs / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use
D000893:Anti-Inflammatory Agents; D000933:Antifibrinolytic Agents; D000975:Antioxidants; D005343:Fibrinolytic Agents; D047493:PPAR alpha; D011355:Prodrugs; D011345:Fenofibrate