Pemafibrate reduces atherosclerosis-induced lipoproteins in hypertriglyceridemia

In the treatment of patients with hypertriglyceridemia, use of the selective PPARα modulator pemafibrate leads to a significant reduction in triglyceride-rich lipoproteins and small dense low-density lipoprotein cholesterol without inducing hepatic and renal damage or rhabdomyolysis, as reported in a study.

The study included 79 patients with hypertriglyceridemia who had not previously taken fibrate medications. They were given pemafibrate for 24 weeks. Researchers assessed the changes in lipid profiles and various parameters before and after treatment with pemafibrate.

Of the patients, 63 percent had diabetes, 72 percent had nonalcoholic fatty liver disease (NAFLD), and 34 percent had chronic kidney disease. More than half of the patients (58 percent) were on statins. The main glucose-lowering drugs given to patients with diabetes were biguanides (50 percent), SGLT2 inhibitors (42 percent), and DPP-4 inhibitors (38 percent).

The mean dose of pemafibrate at 24 weeks was 0.17 mg/day. Treatment led to a significant reduction in triglyceride, from 312 mg/dL at baseline to 167 mg/dL at week 24. Results of lipoprotein fractionation tests using the PAGE method also showed a significant decrease in the ratio of very low-density lipoprotein and remnant fractionations, both of which are triglyceride-rich lipoproteins.

After pemafibrate treatment, liver injury indices such as alanine transaminase, aspartate transaminase, and gamma-glutamyl transferase significantly decreased. There were no changes seen in body weight, HbA1c, estimated glomerular filtration rate, and creatine kinase levels.