Pemafibrate and other triglyceride-lowering therapies to reduce risk of cardiovascular and metabolic disease

Area of Science:

• Cardiology
• Metabolic Diseases
• Pharmacology

Background:

• High triglycerides (HTG) are a known risk factor for cardiovascular disease (CVD).
• Triglyceride-lowering therapies have shown inconsistent success in reducing CVD risk.
• HTG is associated with adverse metabolic complications, including nonalcoholic fatty liver disease and pancreatitis.

Purpose of the Study:

• To review the effectiveness of recent triglyceride-lowering therapies in patients with hypertriglyceridemia and elevated CVD risk.
• To evaluate the impact of these therapies on cardiovascular events and metabolic complications.
• To discuss the emerging landscape for treating HTG-associated risks.

Main Methods:

• Analysis of three major clinical trials: REDUCE-IT, STRENGTH, and PROMINENT.
• Review of therapies including icosapent ethyl (IPE), EPA/DHA combinations, and pemafibrate.
• Consideration of ongoing trials for novel therapies like apolipoprotein C3 inhibitors.

Main Results:

• Icosapent ethyl (IPE) significantly reduced CVD events by 25% in the REDUCE-IT trial.
• EPA/DHA combination in STRENGTH and pemafibrate in PROMINENT failed to show significant CVD risk reduction.
• Pemafibrate and pegozafermin demonstrated improvements in metabolic complications like nonalcoholic fatty liver disease.

Conclusions:

• HTG poses a significant risk for CVD and metabolic sequelae.
• Current evidence suggests a nuanced approach to triglyceride-lowering therapies is necessary.
• A promising, evidence-based strategy for managing HTG and its complications is emerging.