lipid.siteFibrates (fenofibrate): how it works, status and trials
Approved (generic)PillLowering triglycerides
Fibrates such as fenofibrate switch on PPARα, a protein in the nucleus of liver cells. That raises lipoprotein lipase (LPL), the enzyme that breaks down triglycerides, and lowers apoC-III, so triglycerides fall. In the FIELD trial they did not reduce the main coronary outcome.
In technical terms: Activate PPARα: more LPL, less apoC-III, more fatty-acid oxidation.
The highlighted badge marks where Fibrates (fenofibrate) acts. Open the full map or compare every therapy.
At a glance
- Acts on
- PPARα · liver nucleus
- How it is given
- Oral · daily
- What the main trial found
- Lower TG; no reduction in the primary coronary outcome in FIELD
- Status (curated October 25, 2026)
- Approved (generic)
Where it fits in the body
Triglyceride-rich lipoproteins
VLDL from the liver and chylomicrons from the gut carry triglyceride. Lipoprotein lipase (LPL) on capillary walls breaks it down. ANGPTL3 and apoC-III act as brakes on this process. Removing either brake (11–15) lowers triglycerides, and ANGPTL3 blockade also lowers LDL-C without needing LDL receptors, which matters in homozygous FH.
Evidence
- FIELD (PubMed 16310551)
Trials in our database
- Helsinki Heart Study (1987): Benefit
- VA-HIT (1999): Benefit
- FIELD (2005): No significant benefit
- ACCORD Lipid (2010): No significant benefit
- PROMINENT (2022): No significant benefit
Common questions
▸How does Fibrates (fenofibrate) work?
Fibrates such as fenofibrate switch on PPARα, a protein in the nucleus of liver cells. That raises lipoprotein lipase (LPL), the enzyme that breaks down triglycerides, and lowers apoC-III, so triglycerides fall. In the FIELD trial they did not reduce the main coronary outcome. In technical terms: Activate PPARα: more LPL, less apoC-III, more fatty-acid oxidation. It acts on PPARα · liver nucleus.
▸How much does Fibrates (fenofibrate) lower cholesterol or other lipids?
Lower TG; no reduction in the primary coronary outcome in FIELD. Individual results differ, and a clinician can say what to expect for one person.
▸Is Fibrates (fenofibrate) approved, and what is the status?
Approved (generic) (curated October 25, 2026).
▸How is Fibrates (fenofibrate) taken?
Oral · daily.
Read more
Related therapies
- Evinacumab (Evkeeza): Approved 2021 (HoFH)
- Olezarsen (Tryngolza) and volanesorsen: Olezarsen approved 2024; volanesorsen EU only
- Plozasiran (Redemplo): Approved Nov 2025 (FCS)
- Icosapent ethyl (Vascepa): Approved
Not medical advice. Mechanism and status text curated October 25, 2026; registry data refreshed November 1, 2026. Registries can lag company announcements. Effects are placebo-adjusted results from the main published trial, not head-to-head comparisons. Investigational agents are available only in clinical trials. lipid.site is not a healthcare provider. Talk to your clinician before starting or stopping any treatment. If you have chest pain or signs of a stroke, call 911.