Q. Are Fibrates effective at lowering TG levels?

Fibrates are effective at lowering TG levels by 20 per cent to 50 per cent and raising HDL by 10-35 per cent. LDL reduction varies with the agent used and may range from 5 per cent-20 per cent in patients who are not hypertriglyceridemic. Although a higher mortality rate was seen in the clofibrate arm of the World Health Organization study, such a finding was not seen in subsequent studies of gemfibrozil or bezafibrate. These agents have been demonstrated to impart reduction in risk of CAD events and are of use to treat mixed hyperlipidemia. Although these agents are often used in combination with statin therapy, there are no studies demonstrating reduction in clinical events with this approach. This combination increase the risk of myopathy. For patients with very high TG levels, fibrate therapy reduces the risk for pancreatitis.