Modest benefit of fibrates for primary prevention of cardiovascular disease

There was moderate-quality evidence that, in the primary prevention of CVD, currently used fibrates lower the risk of a combined outcome of CVD death, non-fatal myocardial infarction (MI) or non-fatal stroke by 16%, and the risk of a combined outcome of coronary heart disease death or non-fatal MI by 21%. This was achieved without increasing or decreasing overall mortality or non-CVD mortality (low-quality evidence). Very low-quality evidence suggested no difference in discontinuation of treatment due to adverse effects in the fibrate groups compared with placebo groups. Nevertheless, the beneficial effects of fibrates in terms of a decreased risk for major CVD events without background therapy with statins appeared modest on an absolute scale (≤1%).