[Fibrates in the light of large clinical trials]

Peroxisome proliferator-activated receptor (PPAR)α activators (fibrates) are one of the major group of hypolipidemic agents, that have been presented to have clinical benefits in prevention and treatment of cardiovascular disorders. Apart from their well-known hypolipidemic properties, fibrates produce other so-called pleiotropic effects, including anti-inflammatory and anti-oxidant action, as well as reduction in procoagulant activity and improvement in endothelial function. These observations are in line with some of the results from large randomised clinical trials, which indicated the benefits from therapy with fibrates other than we could expect from their hypolipidemic properties. Nevertheless, the analysis of these studies supports the argument that patients with mixed dyslipidemia and carbohydrate metabolism disturbances are the group, which benefits the most from fibrate therapy. In this article, particular attention is devoted to the results of the large clinical trials. We try to explain the differences between the results of various studies.