Is it time to stop treating dyslipidaemia with fibrates?
OBJECTIVE
To determine whether evidence from randomised clinical trials supports the use of fibrates to reduce non-fatal and fatal cardiovascular events in patients with dyslipidaemia.


METHODS
Review of randomised clinical trials of fibrates that assess clinical outcomes.


RESULTS
In clinical trials which have which have included over 40,000 patients there was no difference in all cause mortality for patients randomised to a fibrate compared to placebo. Treatment with a fibrate was associated with a small reduction in the risk of non-fatal cardiovascular events.


CONCLUSIONS
Current evidence does not support the use of fibrates to reduce cardiovascular mortality. Other proven strategies including statins, aspirin, angiotension converting enzyme (ACE) inhibitors, good blood pressure control, and lifestyle interventions should be used to reduce cardiovascular risk.
Benatar
Jocelyne R
JR
Cardiovascular Research Unit, Green Lane Clinical Centre, Green Lane, Auckland. JBenatar@adhb.govt.nz
Stewart
Ralph A
RA
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control; D002995:Clofibric Acid / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D050171:Dyslipidemias / Q000188:drug therapy*; D011345:Fenofibrate / Q000627:therapeutic use; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D011758:Pyrroles / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic
D000806:Angiotensin-Converting Enzyme Inhibitors; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D011758:Pyrroles; D002995:Clofibric Acid; D000069059:Atorvastatin; D011345:Fenofibrate