Paradoxical severe decrease in serum HDL-cholesterol after treatment with a fibrate
Crook et al recently reported a paradoxical decrease in serum high density lipoprotein-cholesterol (HDL-C) in a patient who was receiving fibrate (bezafibrate) treatment for hyperlipidaemia.1 Reviewing the literature, they rightly highlighted some of the characteristics that have so far been observed in association with this phenomenon, namely: (1) it occurs with fibrate monotherapy, in addition to when fibrates have been combined with other hypolipidaemic agents; (2) it appears to be a class effect of the fibric acid derivative group of drugs, having been seen with all the major fibrates; (3) there may sometimes be a …
