Efficacy and Safety of Pemafibrate, a Novel Selective Peroxisome Proliferator-Activated Receptor α Modulator (SPPARMα): Pooled Analysis of Phase 2 and 3 Studies in Dyslipidemic Patients with or without Statin Combination

• Main Authors: Shizuya Yamashita, Hidenori Arai, Koutaro Yokote, Eiichi Araki, Mitsunori Matsushita, Toshiaki Nojima, Hideki Suganami, Shun Ishibashi
• Format: Article
• Language: English
• Published: MDPI AG 2019-11-01
• Series: International Journal of Molecular Sciences
• Subjects: pemafibrate; triglyceride; selective peroxisome proliferator-activated receptor (ppar)α modulator; renal dysfunction; lipoprotein subclass; high-performance liquid chromatography (hplc), concomitant statin
• Online Access: https://www.mdpi.com/1422-0067/20/22/5537

Hypertriglyceridemia has emerged as an independent risk factor for cardiovascular events, despite low-density lipoprotein-cholesterol (LDL-C) well-controlled with statins. We pooled data from the first 12 weeks of six randomized double-blind placebo-controlled studies of pemafibrate in Japan and investigated its efficacy and safety with and without statins, particularly focusing on patients with renal dysfunction. Subjects were 1253 patients (677 in the &#8220;with-statin&#8221; group and 576 in the &#8220;without-statin&#8221; group). At Week 12 (last observation carried forward), triglyceride (TG) was significantly reduced at all pemafibrate doses (0.1, 0.2, and 0.4 mg/day), both with and without statin, compared to placebo (<i>p</i> &lt; 0.001 vs. placebo for all groups). In the &#8220;with-statin&#8221; group, the estimated percent change from baseline was &#8722;2.0% for placebo and &#8722;45.1%, &#8722;48.5%, and &#8722;50.0%, respectively, for the pemafibrate groups. Findings for both groups showed significant decreases in TG-rich lipoproteins and atherogenic lipid parameters compared to placebo. The incidence of adverse events was similar between the pemafibrate and placebo groups and was also similar for patients with and without renal dysfunction in the &#8220;with-statin&#8221; group. Pemafibrate lowered TG and improved atherogenic dyslipidemia without a significant increase in adverse events in comparison to the placebo, even among &#8220;with-statin&#8221; patients who had renal dysfunction.