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Update on the use of fibrates: focus on bezafibrate

Ilan Goldenberg1, Michal Benderly, Uri Goldbourt

  • 1Heart Institute, Shiba Medical Center Tel Hashomer, Israel. ilan.goldenberg@heart.rochester.edu

Vascular Health and Risk Management
|July 17, 2008
PubMed

Insights

Fibrates effectively treat high triglycerides and low HDL-C, improving cardiovascular health. This review details their mechanisms and clinical trial efficacy for dyslipidemia.

Area of Science:

  • Cardiovascular Medicine
  • Lipid Metabolism
  • Pharmacology

Background:

  • Low-density lipoprotein-cholesterol (LDL-C) is a known coronary heart disease (CHD) risk factor, but its predictive ability is limited.
  • Elevated triglycerides with low high-density lipoprotein-cholesterol (HDL-C) dyslipidemia is a significant cardiovascular risk factor, independent of LDL-C.
  • Fibric acid derivatives (fibrates) have been used for over two decades to manage dyslipidemia.

Purpose of the Study:

  • To review the mechanism of action and metabolic effects of fibrates.
  • To summarize clinical trial data on the efficacy of fibrate therapy for dyslipidemia.
  • To detail findings from the Bezafibrate Infarction Prevention trial.

Main Methods:

  • Review of existing literature on fibrate mechanisms and clinical trials.
  • Analysis of data from primary and secondary prevention trials.
  • Examination of subgroup analyses from the Bezafibrate Infarction Prevention trial.

Main Results:

  • Fibrates decrease triglyceride levels and increase HDL-C levels.
  • Fibrates impact apolipoprotein synthesis, lipoprotein metabolism, fibrinolysis, and inflammation via PPARα.
  • Clinical trials demonstrate fibrate efficacy in patients with raised triglycerides-low HDL-C dyslipidemia.

Conclusions:

  • Fibrates are effective in managing dyslipidemia characterized by high triglycerides and low HDL-C.
  • Fibrate therapy offers significant metabolic and long-term cardiovascular benefits.
  • Bezafibrate therapy shows promising metabolic and cardiovascular effects.

Keywords:
cardiac eventsfibrateshigh-density lipoprotein-cholsterolmetabolic syndromeperoxisome proliferator-activated α-receptors

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