Pemafibrate for primary biliary cholangitis with dyslipidemia: A proposal of a new treatment from Japan

Tanaka, Naoki; Honda, Akira

doi:10.1111/hepr.13770

Cited by 3 publications

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References 8 publications

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“…Although hepatotoxicity, renotoxicity, and rhabdomyolysis are the main adverse effects of conventional fibrates, the frequency of these events is reportedly low for PEM [ 11 , 14 , 15 , 16 , 17 ]. The usefulness of PEM for dyslipidemic patients with NAFLD or primary biliary cholangitis have documented [ 18 ]. Moreover, PEM can be used in patients with impaired renal function due to its excretion in the bile [ 19 , 20 , 21 ].…”

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confidence: 99%

Clinically Relevant Dose of Pemafibrate, a Novel Selective Peroxisome Proliferator-Activated Receptor α Modulator (SPPARMα), Lowers Serum Triglyceride Levels by Targeting Hepatic PPARα in Mice

et al. 2022

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Pemafibrate (PEM) is a novel lipid-lowering drug classified as a selective peroxisome proliferator-activated receptor α (PPARα) modulator whose binding efficiency to PPARα is superior to that of fibrates. This agent is also useful for non-alcoholic fatty liver disease and primary biliary cholangitis with dyslipidemia. The dose of PEM used in some previous mouse experiments is often much higher than the clinical dose in humans; however, the precise mechanism of reduced serum triglyceride (TG) for the clinical dose of PEM has not been fully evaluated. To address this issue, PEM at a clinically relevant dose (0.1 mg/kg/day) or relatively high dose (0.3 mg/kg/day) was administered to male C57BL/6J mice for 14 days. Clinical dose PEM sufficiently lowered circulating TG levels without apparent hepatotoxicity in mice, likely due to hepatic PPARα stimulation and the enhancement of fatty acid uptake and β-oxidation. Interestingly, PPARα was activated only in the liver by PEM and not in other tissues. The clinical dose of PEM also increased serum/hepatic fibroblast growth factor 21 (FGF21) without enhancing hepatic lipid peroxide 4-hydroxynonenal or inflammatory signaling. In conclusion, a clinically relevant dose of PEM in mice efficiently and safely reduced serum TG and increased FGF21 targeting hepatic PPARα. These findings may help explain the multiple beneficial effects of PEM observed in the clinical setting.

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