Fibrates: What Have We Learned in the Past 40 Years?

James M. Backes, Pharm.D.; Cheryl A. Gibson, Ph.D.; Janelle F. Ruisinger, Pharm.D.; Patrick M. Moriarty, M.D.


Pharmacotherapy. 2007;27(3):412-424. 

In This Article


The full story of fibric acid derivatives is yet to be told. Early studies involving clofibrate were disappointing because of only modest reductions in CHD events and considerable safety concerns regarding cancer and gallstones. The HHS, which used gemfibrozil, provided reassurance in terms of long-term safety of fibrates and demonstrated significant reductions in CHD events, but did not reduce overall mortality. Post hoc analyses of fibrate trials evaluated the data of patients with lipid profiles more conducive to the effects of fibric acid derivatives. The favorable results of these studies suggest a potential value with these agents when used in appropriate populations. With the publication of the FIELD study came expectations of solidifying a larger market for fibrates in treatment of cardiovascular disease; however, due to mixed results, yet another trial is needed to better determine the best targeted usage of these agents. Results of the ongoing ACCORD trial, which is using fenofibrate, may determine if this class will once again play a greater role in the lipid arena.


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