Antilipidemic Agents Research Articles

The Influence of Comorbidities, Risk Factors, and Medications on Sexual Activity in Individuals Aged 40 to 59 Years With and Without Cardiac Conditions: US National Health and Nutrition Examination Survey, 2011 to 2012.

Sexual activity is increasingly recognized as an important aspect of quality of life for many individuals with cardiovascular disease, although less is known about the factors contributing to sexual functioning in younger adults. This study examined factors influencing sexual activity in individuals aged 40 to 59 years, comparing those reporting a cardiac condition with those without a cardiac condition, in a national population-based sample. The data were derived from the 2011 to 2012 National Health and Nutrition Examination Survey, a publicly available data set with a noninstitutionalized nationally representative sample. The sample included individuals between the ages of 40 and 59 years (N = 1741) who completed relevant items related to cardiovascular disease, cardiovascular risk factors, comorbidities, cardiac symptoms, sexual activity, and medication use. Recommended weighting was applied, and the data were analyzed using χ and logistic regression. Overall, 94% of the sample reported sexual activity, although those with coronary artery disease, angina, and myocardial infarction engaged in significantly less sexual activity. Individuals who smoked; had a weight problem, depression, or lung problems; or experienced symptoms of shortness of breath or chest pain with exertion reported less sexual activity. Medications negatively affecting sexual function were central α agonists, potassium sparing diuretics, and antilipidemic agents. Predictors of less sexual activity were smoking, chest pain walking uphill, and weight problems. Unexpectedly more reported, sexual activity was predicted by one or more cardiac conditions. In men and women ages 40 to 59 years, certain cardiac conditions, risk factors, comorbidities, symptoms, and medications negatively affected sexual activity, illustrating the need for sexual assessment and counseling to support sexual quality of life.

Preparation and Evaluation of Mucoadhesive Nanoparticles of Rosuvastatin

Mucoadhesive nanoparticles constitute one of the important novel drug delivery systems, which cause localization of the drug at the site of absorption. The aim of this study was to prepare mucoadhesive nanoparticles of rosuvastatin calcium, an antilipidemic agent. Rosuvastatin calcium nanoparticles were prepared employing the precipitation technique and were characterized using Fourier-transform infrared spectroscopy, differential scanning calorimetry, X-ray powder diffraction, scanning electron microscopy and by estimating their zeta potential and in vitro drug release. Results indicated that gastroretentive nanoparticle formulation could be developed to release rosuvastatin for up to 8 hours in the stomach.

Biochemical Therapeutic Benefits of Garlic on Atherosclerosis Induced by Soybean in Rats

Setting: For centuries, garlic (Allium sativum. L) plays an important medicinal role and culinary value. Cardiovascular disease (CV) is a complex disease associated with hypercholesterolemia. Aim of the work: The study was designed to evaluate the efficacy of dietary supplementation with garlic juice on hypercholesterolemia induced by a high dietary soybean oil extract and cholesterol in animal (male wistar rats). Animals and methods: Animals were divided into three groups (each group was eight rats). Group one (control rats group) was fed with a control diet made up of the normal rat chow (C), group two of animals was fed with a hypercholesterolemic diet (HPC) enriched with 25% soybean oil and 1% cholesterol for 8 weeks and group three received a hypercholesterolemic diet (HPC) enriched with 25% soybean oil and 1% cholesterol as in second group simultaneously with daily oral administration of 1 ml of garlic juice/100 g body weight (equivalent to 4/10 g/100 g BW) for 8 weeks. Results: The total cholesterol concentrations (TC), the low density lipoprotein concentrations (LDL-C), the high density lipoprotein concentrations (HDL-C), and the ratio of triglycerides were investigated. The concentrations of total cholesterol (TC), low density lipoprotein (LDL-c) and the triglycerides was significantly increased in the serum of rats fed with the dietary intake of the hypercholesterolemic (HPC) diet. No significant difference in the HDL-C concentrations. Rats which were fed with the hypercholesterolemic (HPC) diet was observed weight loss of body and organs, heart, kidney, liver and abdominal fat. Significant better lipidemic status and weight improvement of the body and organs showed with the rats on a hypercholesterolemic (HPC) diet treated with a garlic juice. Therefore, the study suggested that garlic juice is an important determinant of serum lipid concentrations and weight, so it is considered as an antilipidaemic agent against the pathogenesis of atherosclerosis.

PCV96 - A Cost Effectiveness Analysis of Rosuvastatin Against Atorvastatin in Cardiovascular Diseases and Stroke: An Ambispective Study

Statins are antilipidemic agents which are widely used as standard therapy for primary and secondary prevention of cardiovascular diseases (CVD) and stroke caused due to elevated cholesterol levels and atherosclerosis. Atherosclerosis being a complex process can be efficiently treated by statins. The main objective of the current study is to assess the cost effectiveness of rosuvastatin and atorvastatin in primary and secondary prevention of CVD and stroke conditions. A Cross sectional ambispective study was conducted in tertiary care hospitals in Warangal, Telangana, India. The 120 patients who were on statins therapy were interviewed and 60 patients were enrolled in to the study based on inclusion and exclusion criteria of the study. Drug costs, number of events avoided and lipid profiles were recorded, cost effectiveness ratio was determined. Markov model was used and statistical comparisons are done. PRIMARY PREVENTION GROUP (rosuvastatin 5mg, 10mg against atorvastatin 10mg, 20mg) revealed that patients receiving rosuvastatin showed less fluctuations and maintained optimum lipid levels such as serum cholesterol of 173±37.4 mg/dl and 186.7±33.09mg/dl, High density lipoprotein (HDL) of 44.2±18.84mg/dl and 42.8±3.82mg/dl, triglycerides of 169±137.5mg/dl and 119.6±49.4mg/dl, low density lipoprotein of 106±27.32mg/dl and 119.0±32.37mg/dl for atorvastatin and rosuvastatin respectively. SECONDARY PREVENTION GROUP (Rosuvastatin 10mg, 20mg against atorvastatin 40mg, 80mg) revealed that rosuvastatin was most cost effective based on calculated cost effectiveness ratio. The cost of rosuvastatin to avoid an event was found to be Rs 513.90 when compared to Rs 803.37 for atorvastatin. The above results reveal that rosuvastatin was more cost effective drug inspite of its high unit cost when compared with atorvastatin. Further we are continuing the study to increase sample size to draw the effective conclusions.

Predictors of metabolic syndrome in first manic episode.

In the present study we aimed to investigate, whether an association between metabolic syndrome (MetS) and clinical features and affective temperaments exists or not in first manic episode of bipolar disorder (BD) and to clarify the prevalence and predictors of MetS. A total of 150 patients who were received a diagnosis of bipolar disorder type I according to DSM-IV criteria and who were experiencing their first manic episode (FME) were screened consecutively for inclusion. NCEP ATP III formulated an operational definition of MetS based on the presence of three or more of the following characteristics: abdominal obesity (waist circumference), hypertriglyceridemia, low HDL or being on an antilipidemic agent, high blood pressure or being on an antihypertensive agent, and fasting hyperglycemia or being on antiglycemic agent. The patients who had been in remission period for at least 8 weeks were evaluated with SKIP-TURK and TEMPS-A. Remission was defined as YMRS score <5. 37 (32.5%) patients had a MetS. Previous depressive episode, seasonality, negative family history and childhood trauma are determined as the predictors of MetS. Anxious and irritable temperament scores were higher in MetS (+) patients. According to our results, links between MetS and BD may also have been predicted by genetic and environmental factors.

STUDIES ON COMPRESSION AND DRUG RELEASE CHARACTERISTICS OF XANTHIUM GUM PELLETS OF DIFFERENT COMPOSITIONS

The filler used in preparation of pellets affects physical properties, compression and drug release rates . The present investigation was aimed to develop a sustained drug delivery system for a short half life drug, Simvastatin with a view to prolong the release with a sustained release mechanism . Simvastatin is an antilipidaemic agent . Characterization of drug was done by performing the determination of solubility, melting point and FTIR spectroscopy . The prepared batches of pellets were evaluated for micromeritic study such as particle size determination, true density, bulk density, degree of compression, specific surface area and angle of repose . All the batches of pellets were compressed into tablets and evaluated for general appearance, weight vari ation, hardness, content uniformity, and dissolution study . From the results of all these studies, batch F6 was found to show the best results containing Xanthan gum ( 16 %) and Lactose monohydrates ( 8 %) and selected as an optimized batch . The optimized batc h was subjected for further studies such as Scanning Electron Microscopy ( SEM ) to demonstrate pellets morphology and FTIR to determine the drug polymer interaction . Optimized formulation was subjected to accelerate d stability study for a period of 30 days at 40 ± 2 0 C and 75 ± 5 % RH . Formulation was subjected for thickness, hardness, drug content and in - vitro drug release studies at interval of 15 and 30 days .

Pulmonary targeting potential of rosuvastatin loaded nanostructured lipid carrier: Optimization by factorial design

Rosuvastatin (RSVS), an anti-lipidemic agent suggested for the treatment of airway remodeling in chronic obstructive pulmonary disease (COPD). It shows a pleiotropic effect on airway smooth muscles and inhibits proliferative activities of physiological mitogens. The aim of the present study was to develop and investigate the targeting potential of rosuvastatin (RSVS) to lung as loaded in nanostructured lipid carrier dry powder for inhalation (RNLC-DPI). RNLC dispersion was converted into respirable particle by lyophilization using 5% mannitol as cryoprotectant-carrier. Targeting efficiency of RNLC-DPI was evaluated in vitro for aerosol performance using 8-stage cascade impactor as well in vivo in Wistar rats for pulmokinetics. In vitro aerosol performance demonstrated mass median aerodynamic diameter of <3μm with fine particle fraction of >90% at 60L/min. Improved aerosol performance was observed for RNLC-DPI prepared using l-leucin as anti-static agent. Modified in vivo performance with higher Cmax (1.14-fold), improvement in t1/2 (5-fold) and 35-fold improvement in AUC0-∞ indicated significant improvement in bioavailability of RNLC-DPI. Lipidic nature and smaller size of particles helped in bypassing macrophage clearance leading to higher targeting factor. Thus, study demonstrated potential of RNLC-DPI for lung targeting and further for COPD treatment.

Effects of Prednisolone, L-Asparaginase, Gemfibrozil, and Combinations of These Elements on Mice Lipid Profile, Liver, and Pancreas.

The aim of this study is to determine the effects of L-asparaginase (L-ASP), corticosteroids (CSs), and antilipidemics, separately and in combination, on the lipid profiles and the liver and pancreas histology in mice. This study included 8 groups of 7 mice each. Before any drug administration, serum samples were taken from all of the mice. Then, normal saline was applied to the control group, and a medication or combination of medications was applied to the other groups. Levels of triglycerides, cholesterol (COL), and high-density lipoprotein (HDL) and low-density lipoprotein (LDL) were determined, and the livers and pancreases were evaluated histologically at the end of the study. Triglycerides increased significantly in the CS-only and the L-ASP-only groups, COL increased significantly in the CS-only group, and HDL increased significantly in the CS-only and the antilipidemic-only groups. LDL was significantly lower in the CS-only and the L-ASP-only groups. CSs and L-ASP were significantly effective in liver necrosis, L-ASP was significantly effective in liver balloon degeneration, and CS were significantly effective in pancreas vacuolization. Triglyceride measurement is recommended before/during CS and/or L-ASP treatment. Starting with an antilipidemic agent can be considered to avoid possible complications in patients with significantly high rates. Indicators of a possible liver or pancreas injury should also be considered.

Metabolic Syndrome in First Manic Episode: A Comparison between Patients with or without Previous Depressive Episode

Objective: The purpose of this study was to investigate, whether an association between metabolic syndrome (MetS) and clinical features and affective temperaments exists or not in first manic episode of bipolar disorder (BD) with or without previous depressive episode. Methods: Diagnosed with dipolar disorder type I according to DSM-IV criteria fifty four patients who were had a least one previous depressive episode (PDE) and 87 patients who were experiencing their first manic episode (FME) evaluated consecutively for inclusion. Comorbid axis I disorders and alcohol or substance use were excluded. NCEP ATP III formulated an operational definition of MetS based on the presence of three or more of the following characteristics: abdominal obesity (waist circumference), hypertriglyceridemia, low HDL or being on an antilipidemic agent, high blood pressure or being on an antihypertensive agent, and fasting hyperglycemia or being on antiglycemic agent. The patients who had been in remission period for at least 8 weeks were evaluated with SCIP-TURK and TEMPS-A. Remission was defined as YMRS score<5. Results: MetS was found to be more frequent in these patients than the patients who didn’t have a PDE. PDE, negative family history, childhood trauma and seasonality are determined as the predictors of MetS. Anxious temperament scores were higher in MetS (+) FME patients of both groups. Irritable temperament scores were higher only in MetS (+) FME patients without PDE group. Conclusion: The presence of MetS seems to be correlated with the onset and progression of BD. This may also contribute to the discovery of biological markers, increase in our diagnostic tools, development of protective and individual-spesific treatment options.

Understanding reasons for nonadherence to medications in a medicare part d beneficiary sample.

Poor medication adherence is a predictor of poor health outcomes, especially in populations with chronic diseases. Although several self-reported measures of medication adherence exist, the scope of each is limited. To identify barriers to medication adherence in order to facilitate effective delivery of telephone-based medication therapy management (MTM) services to beneficiaries of contracted Medicare Part D plans. This study used a cross-sectional telephone-based questionnaire designed to elicit reasons for low medication adherence. Patients were eligible to participate if they were identified as nonadherent for an antilipidemic, antihypertensive, or antidiabetic agent. Nonadherence was defined as less than 80% of proportion of days covered (PDC). The questionnaire included 17 items pertaining to medication use and 3 demographic items. Data were collected between September 2012 and February 2013. Data analyses included descriptive statistics and Rasch analyses. A total of 124 patients participated in the telephone survey. Of those completing the survey, the majority were patients (97.6%); only 3 surveys (2.4%) were completed by caregivers. The sample population had a mean age of 69.8 years (SD = 9.9), and more than half of participants (60.4%) were female. Nineteen percent of respondents received their medications by mail. Medication nonadherence generated alerts mostly associated with antilipidemic agents (n = 50, 40.3%), followed by antihypertensive drugs (n = 36, 29.0%), and antidiabetic medications (n = 23, 18.5%). The response categories for medication belief items were collapsed from 4 to 3 categories to achieve acceptable Rasch model fit (to fit the model and approximate interval level data). Ten percent of participants reported having medications prescribed either that they did not get or that they obtained but did not use. Almost 30% of patients reported having medications prescribed that they started using but stopped. However, only 4% of patients reporting adherence issues were related to the alert triggering for chronic medications; 96% of reports were linked to unrelated medications that did not generate an alert. The most common reason cited for medication nonadherence was experiencing side effects. Most participants reported positive beliefs about medications and did not report adherence issues related to those triggering alerts. MTM programs offer potential solutions to a number of barriers to medication adherence and a unique opportunity to raise awareness about the importance of medication adherence among members.

"Curcumin, the King of Spices": Epigenetic Regulatory Mechanisms in the Prevention of Cancer, Neurological, and Inflammatory Diseases.

Curcumin (diferuloylmethane), a polyphenolic compound, is a component of Curcuma longa, commonly known as turmeric. It is a well-known anti-inflammatory, anti-oxidative, and anti-lipidemic agent and has recently been shown to modulate several diseases via epigenetic regulation. Many recent studies have demonstrated the role of epigenetic inactivation of pivotal genes that regulate human pathologies, such as neurocognitive disorders, inflammation, obesity, and cancers. Epigenetic changes involve changes in DNA methylation, histone modifications, or altered microRNA expression patterns which are known to be interconnected and play a key role in tumor progression and failure of conventional chemotherapy. The majority of epigenetic changes are influenced by lifestyle and diets. In this regard, dietary phytochemicals as dietary supplements have emerged as a promising source that are able to reverse these epigenetic alterations, to actively regulate gene expression and molecular targets that are known to promote tumorigenesis, and also to prevent age-related diseases through epigenetic modifications. There have been several studies which reported the role of curcumin as an epigenetic regulator in neurological disorders, inflammation, and in diabetes apart from cancers. The epigenetic regulatory roles of curcumin include (1) inhibition of DNA methyltransferases (DNMTs), which has been well defined from the recent studies on its function as a DNA hypomethylating agent; (2) regulation of histone modifications via regulation of histone acetyltransferases (HATs) and histone deacetylases (HDACs); and (3) regulation of micro RNAs (miRNA). This review summarizes the current knowledge on the effect of curcumin in the treatment and/or prevention of inflammation, neurodegenerative diseases, and cancers by regulating histone deacetylases, histone acetyltransferases, and DNA methyltransferases.

Flavanone naringenin: An effective antihyperglycemic and antihyperlipidemic nutraceutical agent on high fat diet fed streptozotocin induced type 2 diabetic rats

Citrus fruits rich in flavonoids elicit their health benefits in prevention/management of metabolic disorders. This study explores the mechanism of naringenin (NG), a flavanone, as an antihyperglycemic and antilipidemic agent on high fat diet (HFD) fed streptozotocin (STZ) induced diabetic rats. NG (25 mg/kg bw) treatment to diabetic rats for 45 days markedly reduced hyperglycemia and hyperinsulinemia, restored lipid profile changes, decreased membrane lipid peroxidation; enhanced the activities of antioxidants and improved hepatic function markers. NG treatment also modulated the expressions of GLUT-4 and TNF-α and restored histological abnormalities in diabetic rats. NG supplementation potentially enhances insulin sensitivity that helps in rebuilding glucose homeostasis in diabetic rats. These findings suggest that NG could be used as a functional and nutraceutical ingredient in combating T2D.

Effects of balanced deep‐sea water on adipocyte hypertrophy and liver steatosis in high‐fat, diet‐induced obese mice

To determine the effects of balanced deep-sea water (BDSW) on adipocyte hypertrophy and liver steatosis in high-fat diet (HFD)-induced obese C57BL/6J mice. BDSW was prepared by mixing deep-sea water (DSW) mineral extracts and desalinated water. C57BL/6J mice were fed a normal diet or HFD with or without BDSW with different hardness (500, 1000, or 2000) for 20 weeks. BDSW suppressed body weight gain in HFD-fed mice. Histopathologic assays of the fat and liver revealed that BDSW inhibited the increase in adipocyte size and improved severe liver steatosis in HFD-fed mice. BDSW suppressed the expression of adipogenic, lipogenic, lipolytic, and pro-inflammatory cytokine genes and increased the expression of adipokines and β-oxidation genes in fat. In the liver, BDSW suppressed the expression of genes involved in lipogenesis and cholesterol synthesis, and increased the expression of genes related to β-oxidation. Furthermore, BDSW improved the impaired phosphorylation of IRS-1, LKB1, AMPK, and mTOR in fat and liver tissues of HFD-fed mice. These results suggest that BDSW has potential as an anti-lipidemic agent, given its ability to suppress body weight gain and liver steatosis through the regulation of lipid metabolism by signal molecule activation.

Evaluation of Chrysin as an Effective Antilipidemic Agent

Evaluation of Chrysin as an Effective Antilipidemic Agent

Everolimus Monotherapy or Combined Therapy in Liver Transplantation: Indications and Results

IntroductionEverolimus is a potent immunosuppressant with several advantages over calcineurin inhibitors, such as good tolerance, preventive effects on cardiovascular morbidity, and mortality and cancer prevention as it inhibits cell proliferation. Patients and MethodsBetween April 1986 and December 2010, we performed 1500 liver transplants (OLT) in 1341 recipients, including 57 patients who were prescribed everolimus 24 (42.1%) as monotherapy and 33 (57.9%) as treatments combined with other immunosuppressants. We performed a retrospective analysis of our experience with conversion to everolimus in OLT recipients. ResultsThe 43 men and 14 women had a mean overall age at transplantation of 59.1 ± 10 years. The most frequent indication for OLT was hepatocellular carcinoma (HCC; 53.8%). Everolimus was introduced to prevent HCC recurrence (53%), development of de novo tumors (33%), address renal dysfunction (7%), or overcome side effects of other immunosuppressants (7%). We observed a significant improvement in renal function using the estimated glomerular filtration rate (Crockcroft-Gault formula) from 68.5 mL/min before to 74.5 mL/min after switching to everolimus. The 72% of recipients who developed ≥1 adverse event, most frequently showed hyperlipidemia (34.4%). ConclusionBoth monotherapy and combined everolimus regimens were well-tolerated immunosuppressive regimens in liver transplant recipients with recurrent or de novo malignancies. Everolimus improved renal function. The most common side effects were hyperlipidemia, edema, and mouth ulcerations, which were well controlled with anti-lipidemic agents or decreased everolimus dosages.

Bezafibrate plus Ursodeoxycholic Acid for Primary Biliary Cirrhosis

Ursodeoxycholic acid (UDCA) is currently the only effective treatment for early-stage primary biliary cirrhosis (PBC). However, up to one third of

Unexplained Perioperative Hypotension in a Patient Treated with Pine Needle Extract

Pine needle-based products are popular dietary supplements in East Asia for health promotion. Pine needle extract (PNE) are especially known as potential anti-hypertensive and anti-lipidemic agents. We report a case of profound, long-lasting unexplained hypotension during and after anesthesia in a patient treated with PNE. Bedside transthorasic echocardiography (TTE) was used as a part of useful diagnostic modality.

Hypolipidemic and antioxidative effects of curcumin on blood parameters, humoral immunity, and jejunum histology in Hy-line hens.

Turmeric (Curcuma Longa Linn) is a medicinal plant that contains curcumin. There is a growing interest in using curcumin powder (CP) as feed additives for antioxidative and antimicrobial properties to improve human health. This study was conducted to determine the appropriate levels of CP on blood parameters, immunity, and histology of jejunum in hens. A total of 200, 58-wk-old Hy-line hens were randomly distributed into 4 treatments (0%, 0.5%, 1.5%, and 2.5% CP or 0, 5, 15, and 25 g/kg feed, respectively) with 5 replicates (10 birds each) for 8 weeks using the completely randomized design. Blood samples were taken from 2 birds per replicate at weeks 61 and 65 to evaluate blood parameters. On weeks 63 and 65, two birds from each replicate received 0.5 ml SRBC (25%) injection in breast muscle and 7 days later, blood samples were collected to evaluate total Ig, IgG, and IgM titers in serum. Two hens were sacrificed at week 65 for the histological study of jejunum. Curcumin reduced triglycerides at 1.5% and 2.5% and cholesterol and LDL at 2.5% (p<0.05). Improvement of total Ig and IgG titers after the 1(st) and 2(nd) injections were observed. Muscle thickness in jejunum increased (p<0.05) at 1.5% curcumin and the length and surface area of villus were enhanced as well. Our results demonstrate that curcumin can be used as an antioxidant at 1.5% and antilipidemic agent at 2.5% in diet.

In Vitro Antioxidant Effects of Aloe barbadensis Miller Extracts and the Potential Role of These Extracts as Antidiabetic and Antilipidemic Agents on Streptozotocin-Induced Type 2 Diabetic Model Rats

In this study, the total phenolic and flavonoid contents, the 2,2-diphenyl-1-picryl hydrazyl (DPPH) radical scavenging ability and the ferric reducing power (FRAP) of Aloe vera were measured to determine the antioxidant activity of this species. The in vivo antidiabetic effects of the plant were also investigated using streptozotocin-induced type 2 diabetic model rats that were divided into five groups based on the treatment received: (1) water (WC); (2) glibenclamide; (3) concentrated gel extract (Gel-C); (4) ethanol (80%) gel extract (Gel-Et); and (5) ethanol (80%) skin extract of Aloe vera (Skin-Et). Skin-Et, which contained the highest level of total phenolics (62.37 ± 1.34 mggallic acid/kg) and flavonoids (20.83 ± 0.77 mg/kg), exhibited the highest scavenging activity (85.01 ± 0.52%) and the greatest reducing power (185.98 ± 0.41 µM), indicating that the skin contained the highest level of antioxidants. The oral consumption of Gel-Et for 4 weeks a caused significant reduction in the fasting serum glucose levels of the rats. The rats in the Gel-C-, Gel-Et- and Skin-Et-treated groups experienced a reduction in their total cholesterol levels by 11%, 17% and 25%, respectively and a reduction in their LDL cholesterol levels by 45%, 3% and 69%, respectively. The in vivo experimental antioxidant parameter MDA is strongly correlated with the in vitro antioxidant parameters of flavonoids and polyphenols, namely the DPPH and FRAP values (r = 0.94, 0.92, 0.93, 0.90), thus confirming the antioxidant potential of the Aloe vera extracts.

Use of fibrates and cancer risk: a systematic review and meta-analysis of 17 long-term randomized placebo-controlled trials.

BackgroundFibrates comprise a class of well-established antilipidemic agents that significantly reduce cardiovascular events. Given the concerns of cancer with fibrate therapy, we undertook a systematic review and meta-analysis to investigate the effects of fibrates on cancer outcomes.MethodsWe systematically searched Medline, Scopus, SCI Expanded, and the Cochrane Library for studies published up to 2012. We included randomized controlled trials (RCTs) that evaluated a fibrate therapy compared with placebo, had a minimum duration of two years, and reported data on the incidence of and/or deaths from cancer during the trial. Reviews of each study were performed and the relative data were abstracted. Pooled relative risk estimates (RR) and 95% confidence intervals (CIs) were calculated using the inverse variance weighted approach. Subgroup, sensitivity and meta-regression analyses were also conducted.ResultsSeventeen RCTs, involving 44,929 participants with an average follow-up of 5.2 years, contributed to the analysis. The degree of variability between trials was consistent with what would be expected to occur by chance alone. The quantitative synthesis of data retrieved from the RCTs was not indicative of a fibrate effect on cancer incidence (780 [fibrate] vs 814 [control]; RR = 1.02, 95% CI 0.92–1.12) or cancer death (385 [fibrate] vs 377 [control]; RR = 1.06, 95% CI: 0.92–1.22). When the analysis was restricted to major RCTs, the results did not substantially change. Similarly, we found no evidence of differential effects by length of follow-up or type of fibrate. Insignificant results were also obtained for the role of fibrates in cancers of the respiratory tract, breast, colon, gastrointestinal tract, prostate, genitourinary tract, or in melanoma.ConclusionOur findings demonstrate that fibrates have a neutral effect on cancer outcomes. However, it is important to continue monitoring their long-term safety profiles.