一个强效和选择性的PPAR-α激动剂在患有动脉动脉性失脂症或高胆固醇血症的患者的影响:两个随机对照试验
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
概括
LY518674,一种强大的PPAR-alpha激动剂,有效降低了三甘油,并在患有脱脂症和高胆固醇症的患者中提高了HDL-C. 然而,它也增加了LDL-C和血清肌素,引发了类似于费诺纤维酸盐的安全问题.
科学领域:
- 药理学 药理学是指药理学的学科.
- 心血管医学 心血管医学
- 代谢障碍 代谢障碍 代谢障碍
背景情况:
- 纤维酸被确认为具有适度功效的氧酶增殖器激活受体α (PPAR-α) 激动因子.
- 需要更强效和选择性的PPAR-alpha激动剂来治疗脂质障碍症.
- LY518674代表了一种新的,更强大的PPAR-α激动剂.
研究的目的:
- 评估LY518674的安全性和疗效,一种选择性的PPAR-alpha激动剂.
- 为了比较LY518674与芬诺纤维酸在患有动脉血症的患者中.
- 评估LY518674对高胆固醇血症患者的LDL-C的影响.
主要方法:
- 进行了两项多中心,随机,双盲,安慰剂控制的试验.
- 研究1:患有脂质失调症的患者接受了安慰剂,纤维酸或不同剂量的LY518674持续12周.
- 研究2:患有高胆固醇血的患者接受安慰剂或阿托瓦斯塔丁,随后接受安慰剂或LY518674持续12周.
主要成果:
- 在失脂症患者中,LY518674和 fenofibrate显著增加了HDL-C和降低了甘油三.
- LY518674表明LDL-C的剂量依赖性增加,与芬诺纤维酸不同.
- 无论是LY518674还是 fenofibrate都增加了血清肌素;LY518674在添加到阿托瓦斯塔丁时没有进一步降低LDL-C.
结论:
- 在这两组患者中,LY518674通过降低甘油三和增加HDL-C有效地改善了脂质谱.
- LY518674显著增加的LDL-C和血清肌素引发了安全问题.
- 需要进一步调查,以充分了解LY518674.4的风险-收益概况.
相关概念视频
Atherosclerosis III: Management
296
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
296
Lipid-Lowering Drugs: Statins and Miscellaneous Agents
1.3K
Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
1.3K
Cholesterol: Significance and Regulation
1.2K
Although not a source of energy, cholesterol plays a significant role as a foundational structure for bile salts, steroid hormones, and vitamin D, as well as being a crucial component of plasma membranes. Approximately 15% of blood cholesterol is derived from our diet, with the remainder synthesized from acetyl CoA by the liver and intestines. Cholesterol is eliminated from the body through its conversion into bile salts, which are eventually discarded in the feces.
Considering cholesterol and...
Considering cholesterol and...
1.2K
Treatment for Pulmonary Arterial Hypertension: Prostacyclin Receptor Agonists
439
Prostacyclin receptor agonists are a class of therapeutic agents integral to managing pulmonary arterial hypertension (PAH). These drugs operate by mimicking the action of prostaglandin I2, or PGI2, a naturally occurring compound in the body.
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
These agonists bind to the IPR receptor situated on the plasma membrane of the pulmonary artery smooth muscle cells. This binding triggers a cascade of reactions known as the GS-AC-cAMP-PKA pathway. This pathway results in the relaxation of smooth muscle...
439
Adrenergic Antagonists: Pharmacological Actions of ɑ-Receptor Blockers
1.3K
α-Adrenergic antagonists, known as α-blockers, exert their effects by inhibiting α-adrenoceptors, leading to specific physiological actions. α1-blockers and α2-blockers have distinct pharmacological actions and therapeutic applications.
α1-blockers: These drugs inhibit α1-adrenoceptors on smooth muscle cells, resulting in vasodilation. This vasodilation lowers blood pressure, making α1-blockers valuable in treating hypertension. Additionally,...
α1-blockers: These drugs inhibit α1-adrenoceptors on smooth muscle cells, resulting in vasodilation. This vasodilation lowers blood pressure, making α1-blockers valuable in treating hypertension. Additionally,...
1.3K
Adrenergic Agonists: Direct-Acting Agents
2.6K
Drugs that mimic the action of endogenous catecholamines like noradrenaline and adrenaline are called adrenergic agonists or sympathomimetics. Based on their mechanism of action, sympathomimetics can be classified as direct-, indirect-, or mixed-acting sympathomimetics. Direct-acting adrenergic agonists activate adrenoceptors without affecting presynaptic neurons, making them independent of neuronal catecholamine-depleting agents like reserpine and guanethidine.
These agents can be classified...
These agents can be classified...
2.6K


