Fibrate Drug Alone Doesn’t Cut Heart Risks for Type 2’s

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A new study of the lipid-lowering drug fenofibrate (brand names TriCor, Lofibra, and others) has shown that taking it alone may not cut the risk of heart disease in people with Type 2 diabetes.

In a substudy from the Fenofibrate Intervention and Event Lowering in Diabetes (or FIELD) study, 170 people with Type 2 diabetes were randomly assigned to take fenofibrate or a placebo for five years. During this period, the researchers found that atherosclerosis — narrowing of arteries caused by the buildup of fatty plaque that is associated with heart disease, stroke, and peripheral vascular disease — progressed at the same rate in both study groups.

These findings are consistent with the main results of the FIELD study, which found that taking fenofibrate did not lower the rate of “coronary events” (heart attack and death from heart disease) in 9,795 people with Type 2 diabetes. These results were published in 2005 in the journal The Lancet. (See the study abstract here.)

However, fenofibrate may still be effective when used in combination with other cholesterol– and triglyceride-lowering drugs, such as statins. Commenting in 2005 on the main FIELD study results, lead researcher Professor Anthony Keech said, “In the context of the well established benefits of statin therapy in this patient group, the main use of fenofibrate will probably be in combination therapy. This question needs to be considered in future studies.”

I reported on one such study earlier this year (see “Two Lipid Drugs May Be Better Than One”). That shorter-term study found that people who took the statin drug simvastatin and fenofibrate together had fewer markers for cardiovascular disease risk after 12 weeks than those who took either drug alone. That study was paid for by the manufacturers of brand-name simvastatin (Zocor) and fenofibrate (TriCor), although generic versions of these drugs are available, too.

You can find the abstract for the new FIELD substudy in the Journal of the American College of Cardiology online here.

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