Elsevier

Journal of Clinical Lipidology

Volume 12, Issue 1, January–February 2018, Pages 173-184
Journal of Clinical Lipidology

Original Article
Efficacy and safety of pemafibrate (K-877), a selective peroxisome proliferator-activated receptor α modulator, in patients with dyslipidemia: Results from a 24-week, randomized, double blind, active-controlled, phase 3 trial

https://doi.org/10.1016/j.jacl.2017.10.006Get rights and content
Under a Creative Commons license
open access

Highlights

  • Pemafibrate 0.2 to 0.4 mg/d was superior to fenofibrate 106.6 mg/d in triglyceride lowering.

  • Pemafibrate decreased total cholesterol, non-high-density lipoprotein cholesterol, and apolipoprotein B, while it increased high-density lipoprotein and apolipoprotein AI.

  • Adverse drug reactions were significantly fewer in pemafibrate groups.

  • Liver- and kidney-related adverse effects were fewer in pemafibrate groups.

  • Pemafibrate significantly decreased fibrinogen compared with fenofibrate.

Background

To overcome the concerns associated with the use of fibrates, pemafibrate (K-877), a novel selective peroxisome proliferator-activated receptor modulator, was developed. In a previous phase 2 trial, we showed excellent efficacy and safety of pemafibrate in patients with dyslipidemia.

Objective

The objective of the study was to evaluate the efficacy and safety of pemafibrate over 24 weeks in adults with dyslipidemia in comparison with fenofibrate.

Methods

In this multicenter, 24-week, double-blind, clinical study, 225 patients with high triglyceride (TG; ≥150 mg/dL [1.7 mmol/L] and <500 mg/dL [5.7 mmol/L]) and relatively low high-density lipoprotein cholesterol (<50 mg/dL [1.3 mmol/L] in men or 55 mg/dL [1.4 mmol/L] in women) levels were randomized to receive either pemafibrate at 0.2 or 0.4 mg/d or fenofibrate 106.6 mg/d.

Results

Pemafibrate 0.2, 0.4 mg/d and fenofibrate significantly reduced TG levels from baseline by −46.2%, −45.9%, and −39.7%, respectively. As compared with fenofibrate, the least squares mean differences (95% confidence intervals) in TG were −6.5% (−12.0, −1.1) and −6.2% (−11.6, −0.8) in pemafibrate 0.2 and 0.4 mg/d respectively, which showed the superiority of these doses of pemafibrate to 106.6 mg/d of fenofibrate. The incidence rates of adverse drug reactions in pemafibrate groups (2.7% and 6.8%) were significantly lower than that in the fenofibrate group (23.7%). Pemafibrate significantly decreased alanine aminotransferase and gamma-glutamyltransferase levels, whereas fenofibrate increased both of them. The increments of serum creatinine and cystatin C were smaller in pemafibrate than those in fenofibrate.

Conclusions

Pemafibrate was superior to fenofibrate in terms of serum TG-lowering effect and hepatic and renal safety.

Keywords

Selective PPARα modulator
Pemafibrate
K-877
Triglycerides
Dyslipidemia
Liver dysfunction
Fatty liver
Homocysteine
Renal dysfunction
Fibrates

Cited by (0)

This work was supported by Kowa Company, Ltd, who contributed in the study design, data collection, data analysis, data interpretation, and writing of the report.