The DOI matches its Crossref record; 173 of the 173 references it cites were found in a registry or an index.
Fenofibrate: A Review of its Use in Primary Dyslipidaemia, the Metabolic Syndrome and Type 2 Diabetes Mellitus
Abstract
Fenofibrate is a fibric acid derivative indicated for use in the treatment of primary hypercholesterolaemia, mixed dyslipidaemia and hypertriglyceridaemia in adults who have not responded to nonpharmacological measures. Its lipid-modifying effects are mediated by activation of peroxisome proliferator-activated receptor-alpha. Fenofibrate also has nonlipid (i.e. pleiotropic) effects (e.g. it reduces fibrinogen, C-reactive protein and uric acid levels and improves flow-mediated dilatation). Fenofibrate improves lipid levels (in particular triglyceride [TG] and high-density lipoprotein-cholesterol [HDL-C] levels) in patients with primary dyslipidaemia. Its lipid-lowering profile means that fenofibrate is particularly well suited for use in atherogenic dyslipidaemia (characterised by high TG levels, low HDL-C levels and small, dense low-density lipoprotein [LDL] particles), which is commonly seen in patients with the metabolic syndrome and type 2 diabetes mellitus. Indeed, fenofibrate improves the components of atherogenic dyslipidaemia in patients with these conditions, including a shift from small, dense LDL particles to larger, more buoyant LDL particles. Greater improvements in lipid levels are seen when fenofibrate is administered in combination with an HMG-CoA reductase inhibitor (statin) or in combination with ezetimibe, compared with monotherapy with these agents. In the DAIS study, fenofibrate significantly slowed the angiographic progression of focal coronary atherosclerosis in patients with type 2 diabetes. In terms of clinical outcomes, although no significant reduction in the risk of coronary events was seen with fenofibrate in the FIELD trial in patients with type 2 diabetes, treatment was associated with a significantly reduced risk of total cardiovascular disease (CVD) events, primarily through the prevention of non-fatal myocardial infarction and coronary revascularisation. Subgroup analyses revealed significant reductions in total CVD events and coronary heart disease events in patients with no previous CVD, suggesting a potential role for primary prevention with fenofibrate in patients with early type 2 diabetes. Improvements were also seen in microvascular outcomes with fenofibrate in the FIELD trial. Fenofibrate is generally well tolerated, both as monotherapy and when administered in combination with a statin. Combination therapy with fenofibrate plus a statin appears to be associated with a low risk of rhabdomyolysis; no cases of rhabdomyolysis were reported in patients receiving such therapy in the FIELD trial. Thus, fenofibrate is a valuable lipid-lowering agent, particularly in patients with atherogenic dyslipidaemia.
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“FF has been demonstrated to have a somewhat variable effect raising HDLC in large clinical trials ranging from 1.5–7.4% [29].”
From Fenofibrate and metabolic syndrome (2010) · cites this paper as [29]
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[Place of fibrates for the treatment of patients with atherogenic dyslipidemia].
Ducobu, J., Scheen, A. J., Legat, P., Backer, G. D., Gaal, L. V., Velkeniers, B., Kartounian, J., Maes, M., & Hermans, M. P. (2009) · PubMed
Metadata
- Authors
- Keating, G. M., & Croom, K. F.
- Affiliations
- Wolters Kluwer Health (NZ)
- Corresponding author
- Keating, Gillian M
- Venue
- Drugs
- Published
- 2007
- Volume
- 67
- Issue
- 1
- Pages
- 121-153
- ISSN
- 0012-6667 (ISSN-L)
- OpenAlex
- W2005965794
- Cited by
- 169
- References
- 173
- Citations by year
- 2026: 3 · 2025: 13 · 2024: 10 · 2023: 7 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 6 · 2018: 3 · 2017: 7 · 2016: 7 · 2015: 9 · 2014: 8 · 2013: 10 · 2012: 9
- FWCI
- 3.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Drugs (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipid metabolism and disorders
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
- Keywords
- fenofibrate, fibrates, PPARα, primary hypercholesterolemia, mixed dyslipidemia, hypertriglyceridemia, atherogenic dyslipidemia, metabolic syndrome, type 2 diabetes, statin combination therapy, ezetimibe, cardiovascular risk reduction, primary prevention, rhabdomyolysis
- MeSH terms
- Hypolipidemic Agents, Diabetes Mellitus, Type 2, Humans, Fenofibrate, Metabolic Syndrome, Dyslipidemias
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