Fibrates can reduce the risk of major cardiovascular events

January 01, 0001

Fibrates can reduce the risk of major cardiovascular events

Several clinical trials have reported inconsistent findings for the effect of fibrates on cardiovascular risk. The researchers from Australia, China, USA and The Netherlands undertook a systematic review and meta-analysis to investigate the effects of fibrates on major clinical outcomes. They systematically searched Medline, Embase, and the Cochrane Library for trials published between 1950 and March, 2010 and included prospective randomised controlled trials assessing the effects of fibrates on cardiovascular outcomes compared with placebo. They identified 18 trials providing data for 45 058 participants, including 2870 major cardiovascular events, 4552 coronary events, and 3880 deaths.

Fibrate therapy produced a 10% relative risk (RR) reduction for major cardiovascular events and a 13% RR reduction for coronary events (both significant), but had no benefit on stroke. They noted no effect of fibrate therapy on the risk of all-cause mortality, cardiovascular mortality, sudden death, or non- vascular mortality. Fibrates reduced the risk of albuminuria progression by 14%. Serious drug-related adverse events were not significantly increased by fibrates although increases in serum creatinine concentrations were common.

The researchers concluded: " Fibrates can reduce the risk of major cardiovascular events predominantly by prevention of coronary events, and might have a role in individuals at high risk of cardiovascular events and in those with combined dyslipidaemia."

This benefit may have been missed with the move to statins. Studies comparing fibrates to statins (although there is independent data) and combined with statins will be interesting to see.

For the full abstract, click here.

The Lancet published online 11 May 2010
© Elsevier Ltd 2010
Effects of fibrates on cardiovascular outcomes: systematic review and meta-analysis. Min Jun, Celine Foote, Jicheng Lv et al. Correspondence to Dr Vlado Perkovic:

Category: K. Circulatory. Keywords: effects, fibrates, cardiovascular, outcomes, systematic review and meta analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 18 June 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.