TOPLINE:

Children with hypertriglyceridemia treated with fenofibrate had lower levels of triglycerides, low-density lipoprotein cholesterol, and total cholesterol than those treated with omega-3 fatty acids.

METHODOLOGY:

• Researchers conducted a randomized controlled trial in Rasht, Iran (January to June 2023), with 60 patients aged 8-18 years.
• Patients were included if they had triglyceride levels > 400 or > 250 mg/dL unresponsive to diet and exercise.
• Patients were randomly assigned to receive fenofibrate (100 mg) daily or omega-3 (1000 mg fish oil containing 180 mg of eicosapentaenoic acid and 120 mg of docosahexaenoic acid) twice a day for 12 weeks, with 30 patients in each group. Moderate physical activity was recommended by pediatric endocrinologists.
• The primary outcome was the change in lipid profile, with serum triglyceride levels measured after a 12-hour fast using a fully automatic biochemistry analyzer.
• Secondary outcomes were adverse effects, monitored through regular check-ins and daily checklists.

TAKEAWAY:

• After week 12, patients who received fenofibrate had lower triglyceride levels than those who received omega-3 fatty acids (P = .014). Both the fenofibrate and omega-3 groups showed significant reductions in triglyceride levels from baseline to weeks 8 and 12 (P < .001 for both groups).
• Total cholesterol levels decreased significantly in both the groups at weeks 8 (P = .023) and 12 (P < .001). An increase in high-density lipoprotein cholesterol levels was observed in the omega-3 group after week 12 (P = .004), whereas no significant change was noted in the fenofibrate group.
• Mean low-density lipoprotein cholesterol levels differed significantly between the two treatment groups at baseline (P = .024) and week 12 (P < .001). Low-density lipoprotein cholesterol levels decreased in the fenofibrate group over the study period (P < .001), but no significant change was observed in the omega-3 group.
• No significant differences in mean levels of liver enzymes were found at the beginning and end of the study for either group. No notable adverse effects were reported in either group, although three patients in the omega-3 group experienced mild gastrointestinal symptoms.

IN PRACTICE:

“This study shows that fenofibrate is a safe and effective treatment for lowering TG [triglyceride] levels in children and adolescents with hypertriglyceridemia, while omega-3 supplementation may increase HDL-C [high-density lipoprotein cholesterol] levels. It addresses the limited options in pediatric lipid management, as fenofibrate enhances TG clearance through PPAR-[alpha] activation,” wrote the authors of the study.

SOURCE:

The study was led by Setila Dalili, MD, Pediatric Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran. It was published online on February 3, 2026, in the Journal of Pediatric Health Care.

LIMITATIONS:

The sample size of the study was small, and it was conducted at a single center. The follow-up duration was short. The fixed dose of fenofibrate was not adjusted for weight, potentially affecting individual responses. Long-term safety data were lacking.

DISCLOSURES:

The study did not report any specific funding. No relevant conflicts of interest were reported by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.