**2. Clinical efficacy**

The pleiotropic activities other than the lipid-lowering actions reported in clinical practice: the anti-inflammatory, antioxidant, and serum uric acid-reducing actions of fenofibrate are

Fenofibrate: Panacea for Aging-Related Conditions? 449

We compared the anti-inflammatory effects of fenofibrate and statins in 44 patients with a chronic inflammatory disorder: rheumatoid arthritis (RA) (Goto, 2010). Japanese patients with RA and dyslipidemia were randomly divided into 2 groups: fenofibrate (Lipidil, Kaken Pharmaceutical Co., Ltd., micronized fenofibrate at 200 mg/day, n=23) and statins (n=21) groups. After 6-month administration, the laboratory data were compared, and pain was evaluated using the visual analogue scale (VAS) and dose change of prednisolone (PSL) was monitored. The VAS scores significantly decreased in the fenofibrate (from 49.1 to 14.7 mm, p<0.0001) and statin (from 47.4 to 20.2 mm, p<0.001) groups. The dose of PSL significantly reduced only in the fenofibrate group (from 3.58 to 2.00 mg/day, p<0.01). The reduction rate

In the fenofibrate group, a significant correlation was between the rate of change in the ΔVAS score and that in the ΔCRP level (Fig.2. p<0.05). The results suggest that, in patients with RA, fenofibrate exhibits more potent anti-inflammatory effects compared to statins.

VAS visual analogue scale; HDL-C high-density lipoprotein-cholesterol; RF rheumatoid factor; CRP C-

Fig. 2. Fenofibrate administration group: correlation between anti-inflammatory markers

Oxidative stress has been considered to promote aging (Harman, 1978; Yu & Chung, 2001; Romano et al., 2010). As for oxidative stress markers that can be measured on clinical examination, serum lipids, MDA-LDL and Ox-LDL, and urinary lipids, 8-OHdG and 15 isoprostane F2t: 8-epi-PGF2α/8-isoPGF2α, are employed (Harman, 1978; Yu& Chung, 2001). Coenzyme Q10 (CoQ10), also known as ubiquinone shows antioxidant actions and has been

CoQ10 is biosynthesized from mevalonic acid in the liver. As the pathway of CoQ10 biosynthesis is partially overlapped with that of cholesterol synthesis, the administration of an HMG-CoA reductase inhibitor, statins, reduces the production of CoQ10. Therefore,

reactive protein; ESR erythrocyte sedimentation rate; PSL prednisolone

monitored as an in vivo marker of oxidative stress.

was also significantly better than in the statin group (Fig. 1).

Spearman rank correlation coefficient

**2.1.2 Antioxidant actions** 

and ΔVAS.

reviewed in this section. These activities may be tightly associated with anti-aging actions of fenofibrate. Three large-scale, randomized, comparative clinical studies of fenofibrate ("DAIS", "FIELD" and "ACCORD"), in which intervention was performed in patients with type II diabetes mellitus (DM), were published since 2000.
