Hypertriglyceridemia Therapy: Past, Present and Future Perspectives.

Area of Science:

• Cardiovascular Medicine
• Pharmacology
• Metabolic Diseases

Background:

• Hypertriglyceridemia is a key risk factor for cardiovascular diseases.
• Fibrates are a crucial class of lipid-lowering drugs for dyslipidemia management.
• Fibrates activate peroxisome proliferator-activated receptor (PPAR)-α, impacting lipid profiles.

Purpose of the Study:

• To review the role of fibrates in managing hypertriglyceridemia and cardiovascular risk.
• To discuss the mechanisms, efficacy, and safety of fibrates, including drug interactions.
• To highlight emerging therapies for triglyceride reduction.

Main Methods:

• Review of existing literature on fibrate pharmacology and clinical use.
• Analysis of pharmacokinetic interactions between fibrates and statins.
• Examination of new therapeutic agents and their mechanisms of action.

Main Results:

• Fibrates effectively lower triglycerides and increase HDL cholesterol via PPAR-α activation.
• Fibrate monotherapy carries a risk of myopathy, amplified by co-administration with statins.
• Gemfibrozil significantly interacts with statin pharmacokinetics; fenofibrate has a lesser impact.
• Pemafibrate, a selective PPAR-α agonist, is under investigation.
• Novel therapies with distinct mechanisms are emerging for triglyceride management.

Conclusions:

• Fibrates are essential for managing hypertriglyceridemia and reducing cardiovascular risk.
• Careful consideration of drug interactions, particularly with statins, is necessary.
• Ongoing research and development are expanding therapeutic options for dyslipidemia.