アテロゲン性不脂血症または高コレステロール血症の患者における強力で選択的なPPAR-αアゴニストの効果:ランダム化比較試験2件
Steven E Nissen1, Stephen J Nicholls, Kathy Wolski
1Department of Cardiovascular Medicine, Cleveland Clinic Lerner School of Medicine, Cleveland, Ohio 44195, USA. nissens@ccf.org
JAMA
|March 27, 2007
まとめ
強力なPPAR-αアゴニストであるLY518674は,トリグリセリドを効果的に低下させ,脂質不全や高コレステロール血症の患者でHDL-Cを上昇させた. しかし,LDL-Cと血清クレアチニンも増加し,フェノフィブラートと同様の安全性に関する懸念を引き起こしました.
科学分野:
- 薬理学 薬理学とは
- 心血管医学は,心臓血管医学である.
- メタボリック障害 メタボリック障害
背景:
- 繊維は,控えめな有効性を持つペロキシソーム増殖器活性化受容体アルファ (PPAR-alpha) アゴニストとして確立されています.
- 脂質不全症の治療には,より強力で選択的なPPAR-αアゴニストが必要である.
- LY518674は,新しい,より強力なPPAR-alphaアゴニスト剤を表しています.
研究 の 目的:
- 選択的PPAR-αアゴニストであるLY518674の安全性と有効性を評価する.
- LY518674とフェノフィブラートを,アテロゲン性脂質不全症の患者で比較する.
- 高コレステロール血症患者のLDL-Cに対するLY518674の効果を評価する.
主な方法:
- 2つのマルチセンター,ランダム化,ダブルブラインド,プラセボ対照試験を実施しました.
- 試験1: 脂質不全症の患者は,プラセボ,フェノフィブラート,または異なる量のLY518674を12週間投与されました.
- 研究2:高コレステロール血症の患者は,プラセボまたはアトルバスタチンを投与し,次にプラセボまたはLY518674を12週間投与した.
主要な成果:
- LY518674とフェノフィブラートは,脂質不全患者でHDL-Cを有意に増加させ,トリグリセリドを減少させた.
- LY518674は,フェノフィブラートとは異なり,LDL-Cの量に依存する増加を示した.
- LY518674とフェノフィブラートの両方が血清クレアチニンを増加させ,LY518674はアトルバスタチンと併用するとLDL-Cをさらに低下させなかった.
結論:
- LY518674は,トリグリセリドを低下させ,両方の患者群でHDL-Cを増加させることで,脂質プロフィールを効果的に改善しました.
- LY518674のLDL-Cと血清クレアチニンの有意な増加は,安全性の懸念を提起しています.
- LY518674.4の利益リスクプロフィールを完全に理解するために,さらなる調査が必要である.
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