Which class of medication primarily aims to lower serum triglycerides?

Fibrates primarily aim to lower serum triglycerides by activating peroxisome proliferator-activated receptors (PPARs), specifically PPAR-alpha. This activation leads to an increase in fatty acid oxidation in the liver and muscle tissues, which enhances the clearance of triglyceride-rich lipoproteins from the bloodstream. Fibrates also work by reducing the production of triglycerides in the liver, thereby lowering the overall triglyceride levels in the serum.

While statins are effective at lowering LDL cholesterol and have some effect on triglycerides, their primary action is focused on cholesterol metabolism. Bile acid sequestrants are used to lower cholesterol levels by binding bile acids, which leads to increased excretion of cholesterol, but they are not specifically targeted at lowering triglycerides. Niacin can lower triglycerides as well, but it has a more pronounced effect on increasing HDL cholesterol. Thus, fibrates are specifically the go-to medication class for effectively reducing serum triglyceride levels.