Fenofibrate and Telmisartan in the Management of Abdominal Aortic Aneurysm

Curr Drug Targets. 2018;19(11):1241-1246. doi: 10.2174/1389450119666171227224655.


Objective: This mini-review provides the rationale and updated progress for ongoing randomized controlled trials assessing fenofibrate and telmisartan efficacy to limit abdominal aortic aneurysm (AAA) growth.

Methods/results: There remains an urgent need to identify a drug therapy that will limit AAA growth. Data from preclinical and human studies indicate that fenofibrate and telmisartan have the potential to slow aortic destruction. Fenofibrate has been shown to reduce serum and tissue levels of the proinflammatory protein osteopontin, as well as reducing macrophage recruitment to the aortic wall, both of which are integral processes in the development and progression of AAAs. Telmisartan acts via blockade of the angiotensin II receptor, type 1, and also as a peroxisome proliferator-activated receptor gamma agonist. In turn, this inhibits the production of a range of biomarkers associated with AAA progression, including transforming growth factor-beta one, osteoprotegerin, osteopontin and matrix metalloproteinase- 9. Based on these findings, there are currently three randomized controlled trials assessing both fenofibrate and telmisartan as potential interventions to limit aneurysm growth in AAA patients.

Conclusion: Fenofibrate and telmisartan have potential as repurposed medications to limit AAA growth, and randomized trials for further assessment in AAA patients are ongoing.

Keywords: Abdominal aortic aneurysm; angiotensin; clinical trial; fenofibrate; osteopontin; telmisartan..

Publication types

  • Review

MeSH terms

  • Animals
  • Aortic Aneurysm, Abdominal / drug therapy*
  • Aortic Aneurysm, Abdominal / metabolism
  • Down-Regulation
  • Fenofibrate / pharmacology
  • Fenofibrate / therapeutic use*
  • Humans
  • Osteopontin / blood
  • PPAR gamma / agonists
  • Randomized Controlled Trials as Topic
  • Receptor, Angiotensin, Type 1 / metabolism
  • Telmisartan / therapeutic use*
  • Treatment Outcome


  • AGTR1 protein, human
  • PPAR gamma
  • PPARG protein, human
  • Receptor, Angiotensin, Type 1
  • SPP1 protein, human
  • Osteopontin
  • Fenofibrate
  • Telmisartan