Review of the Effects of Fenofibrate on Lipoproteins, Apoproteins, and Bile Saturation: US Studies

Abstract

The first well-controlled studies of fenofibrate in the United States indicate that the drug is safe and effective for the treatment of type IIa and type lib hyperlipidemia. Fenofibrate produced a marked reduction in triglyceride (TG) levels (p < 0.01) as well as a uniform decrease in very-low-density lipoprotein (VLDL) cholesterol levels (p < 0.01) and a rise in high-density lipoprotein (HDL) cholesterol levels (p < 0.01) in 227 subjects with both type IIa and IIb hyperlipidemias. Low-density lipoprotein (LDL) cholesterol levels also fell: 20.3% in type IIa and 6% in type IIb subjects. Fenofibrate also affected the structure and composition of some of the major classes of lipoproteins: increases in apolipoproteins (apo) Al and All and decreases in apo B and apo E were consistent with reductions in TG, VLDL, and LDL and increases in HDL. Tolerance of fenofibrate was excellent, with most side effects being transitory or reversible. Thus, based on the lipid hypothesis of atherosclerosis, therapy with fenofibrate can potentially lead to significant reductions in cardiovascular disease in type IIa and type IIb hyperlipoproteinemia.