Is it time to stop treating dyslipidaemia with fibrates?

N Z Med J. 2007 Sep 7;120(1261):U2706.

Abstract

Aim: 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.

Method: Review of randomised clinical trials of fibrates that assess clinical outcomes.

Result: 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.

Discussion: 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.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use
  • Atorvastatin
  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Clofibric Acid / therapeutic use*
  • Diabetes Mellitus, Type 2 / complications
  • Dyslipidemias / drug therapy*
  • Fenofibrate / therapeutic use
  • Heptanoic Acids / therapeutic use
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypolipidemic Agents / therapeutic use*
  • Pyrroles / therapeutic use
  • Randomized Controlled Trials as Topic

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Pyrroles
  • Clofibric Acid
  • Atorvastatin
  • Fenofibrate