New trials renew interest in mature fibrate class of lipid-lowering drug

Two new studies have provided a fillip for a drug class which hasrecently suffered a lapse in recognition, no doubt owing to the excitement, and sales, generated by the HMG-CoA reductase inhibitors (or statins) for lowering blood cholesterol. The fibric acid derivatives may not offer the potency of the statins in reducing low-density lipoprotein cholesterol, but the new trials indicate that they have important effects on other lipid parameters, particularly high-density lipoprotein cholesterol, which suggest they still have a role to play in the management of dyslipidemias.

The Diabetes Atherosclerosis Intervention Study, published in The Lancet (March 24), involved 418 type 2 diabetics for at least three years. The patients had good control of their blood-sugar levels but had lipid abnormalities including reduced levels of HDL cholesterol and raised triglycerides, while LDL cholesterol was normal or mildly raised. These patients are at risk of atherosclerosis, the most common complication of diabetes, and all had at least one visible lesion on angiogram. In addition, half of them had no prior history of clinical coronary disease.

Fenofibrate in DAIS