No proof fibrate drugs reduce heart risk in diabetes patients on statins

Type 2 diabetes patients, who face higher risk of cardiovascular disease, often take a combination of medications designed to lower their low-density lipoprotein (LDL) or "bad" cholesterol and triglyceride levels while raising their high-density lipoprotein (HDL) or "good" cholesterol because doctors long have thought that taken together, the drugs offer protection from heart attacks and improve survival.

However, in a commentary in the current New England Journal of Medicine, a trio of doctors who served on a recent US Food and Drug Administration panel that evaluated the drugs' effectiveness says the commonly prescribed medications have not been proven successful at preventing heart attacks in type 2 diabetes patients with elevated cholesterol.

The drugs, called fibrates, seek to lower blood triglyceride levels and raise the amount of HDL cholesterol. They often are prescribed to diabetes patients as an add-on to statins, drugs that lower LDL cholesterol. Annual sales in the USA for the three fibrates now approved by the FDA - gemfibrozil (Lopid, now off patent), fenofibrate (Tricor, from Abbott Labs) and fenofibric acid (Trilipix, also from Abbott) - amount to billions of dollars.