Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .
Treatment of patients with familial defective apolipoprotein B-100 with pravastatin and gemfibrozil: a two-period cross-over study
Thirty patients with familial defective apolipoprotein B-100 were treated in a two-period ( 8 weeks each ) cross-over study with pravastatin and gemfibrozil .  Cholesterol , LDL cholesterol , and apo B were reduced by 20–25 % ( P < 10−4 ) by pravastatin and by 4–6 % by gemfibrozil ( pravastatin vs. gemfibrozil : P < 10−4 ) . Response to pravastatin was variable and not correlated to gender , age , or apo E genotype . Gemfibrozil  lowered triglycerides by 25 % ( P < 10−4 ) and raised HDL cholesterol by 11 % . The effects of pravastatin on these two interrelated variables were significantly smaller . Both drugs increased Lp(a ) significantly by about 10 % . The LDL cholesterol lowering effect of pravastatin in patients with FDB is similar to that observed in patients with familial hypercholesterolemia
Conclusions Fibrates have a significantly greater effect in reducing plasma Lp(a ) concentrations than statins .
Addition of fibrates to statins can enhance the Lp(a)-lowering effect of statins
Background Raised plasma lipoprotein(a ) ( Lp(a ) ) concentration is an independent and causal risk factor for atherosclerotic cardiovascular disease .
Several types of pharmacological approaches are under evaluation for their potential to reduce plasma Lp(a ) levels .
There is suggestive evidence that statins and fibrates , two frequently employed lipid-lowering drugs , can lower plasma Lp(a ) .
The present study aims to compare the efficacy of fibrates and statins in reducing plasma concentrations of Lp(a ) using a meta- analysis of r and omized head-to-head trials .