Advances in the treatment of rheumatoid arthritis (RA), especially the introduction of biological agents such as tumour necrosis factor α (TNFα) receptor antagonists, neutralising antibodies against TNFα, and interleukin (IL)1 receptor antagonists, have dramatically delayed the progression of this disease.^1–3 Although these agents are clearly beneficial to patients with RA, the prices of these treatments are currently three times the cost of the most expensive conventional disease modifying antirheumatic drug (DMARD).⁴ Therefore, if a new combination therapy could be developed using conventional DMARDs and other conventional drugs, and if this treatment were as effective as, but less costly than, the biological agents, this would be ideal. We describe a patient with RA for whom methotrexate treatment was no longer effective, and who received anti-hyperlipidaemia treatment with fenofibrate, a peroxisome proliferator activated receptor (PPAR) α ligand. This treatment eventually resulted in an improvement in her symptoms. This case suggests that fenofibrate …