A systematic review of the effects of fibrates on major clinical outcomes has shed light on how the drugs fight cardiovascular events.
The research, which involved meta analysis, shows they mainly work by fighting coronary artery disease and preventing the need for angioplasty or stenting.
Article Online First and an upcoming edition of Lancet are publishing the Australian study, authored by a team led by Dr Vlado Perkovic at the University of Sydney.
Trials published between 1950 and March 2010 were analysed. They included prospective randomised, controlled trials assessing the effects of fibrates on cardiovascular outcomes compared with placebo.
The analysis included 18 trials and 45,058 participants, including 2,870 major cardiovascular events, 4,552 coronary events, and 3,880 deaths.
Fibrate treatments produced a 10% RR reduction for major cardiovascular events and a 13% RR reduction for coronary events.
However, fibrate treatment had no significant effect on stroke, all-cause mortality, cardiovascular mortality or sudden death.
Revascularisation events such as angioplasty or stenting were made less necessary.
The authors conclude: "The magnitude of the proportional risk reduction is more modest than that achieved with other vascular preventive therapies targeting lipids, blood pressure, and coagulation, and the clinical relevance of the effect reported here will be debated."