Joshi Shashank R
Lilavati Hospital and Research Centre - Endocrinology , A - 791 Bandra Reclamation Bandra (W), Mumbai, Maharashtra 400050 , India
Expert Opin Pharmacother. 2015 Mar;16(4):597-606. doi: 10.1517/14656566.2015.1009894.
Diabetes and dyslipidemia are commonly associated modifiable risk factors for cardiovascular diseases. Majority of patients with diabetes also suffer from dyslipidemia (diabetic dyslipidemia). Diabetic dyslipidemia is more atherogenic as it is commonly associated with high triglyceride (TG) levels, high proportion of small dense low-density lipoprotein cholesterol and low high-density lipoprotein cholesterol (HDL-C) level (atherogenic dyslipidemia). Currently used pharmacotherapies for the management of diabetes and dyslipidemia like thiazolidinediones (PPAR-γ agonist; for insulin resistance) and fibrates (PPAR-α agonist; for hypertriglyceridemia) have many limitations and side effects. Saroglitazar , a dual PPAR-α/γ agonists, is an emerging therapeutic option with its dual benefit on glycemic and lipid parameters.
This paper reviews the clinical development of saroglitazar for the management of diabetic dyslipidemia. The efficacy and safety profile of saroglitazar is reviewed in context to currently available therapy like pioglitazone for diabetes and fibrates for hypertriglyceridemia. In addition, this paper also reviews the association between diabetes and dyslipidemia and the role of TG in reducing cardiovascular events.
Saroglitazar, a dual PPAR-α/γ agonist, is a potential therapeutic option for the management of diabetic dyslipidemia. It has dual benefit of significant improvement in glycemic parameters (glycated hemoglobin and fasting blood glucose) and significant improvement in dyslipidemia (TGs, apolipoprotein B, non-HDL-C). The results of Phase III clinical trials indicate that saroglitazar is devoid of conventional side effects of fibrates and pioglitazone. Future clinical trials of saroglitazar will further establish its place in the management of diabetes, dyslipidemia and associated cardiovascular risk.
糖尿病和血脂异常是常见的、可改变的心血管疾病风险因素。大多数糖尿病患者也患有血脂异常(糖尿病性血脂异常)。糖尿病性血脂异常更具致动脉粥样硬化性,因为它通常与高甘油三酯(TG)水平、高比例的小而密低密度脂蛋白胆固醇以及低高密度脂蛋白胆固醇(HDL-C)水平相关(致动脉粥样硬化性血脂异常)。目前用于治疗糖尿病和血脂异常的药物疗法,如噻唑烷二酮类(PPAR-γ激动剂;用于胰岛素抵抗)和贝特类(PPAR-α激动剂;用于高甘油三酯血症)有许多局限性和副作用。西格列他扎,一种PPAR-α/γ双重激动剂,作为一种对血糖和血脂参数具有双重益处的新兴治疗选择正在兴起。
本文综述了西格列他扎治疗糖尿病性血脂异常的临床进展。结合目前可用的治疗方法,如用于糖尿病的吡格列酮和用于高甘油三酯血症的贝特类药物,对西格列他扎的疗效和安全性进行了综述。此外,本文还综述了糖尿病与血脂异常之间的关联以及TG在降低心血管事件中的作用。
西格列他扎,一种PPAR-α/γ双重激动剂,是治疗糖尿病性血脂异常的潜在治疗选择。它具有双重益处,能显著改善血糖参数(糖化血红蛋白和空腹血糖)以及显著改善血脂异常(TG、载脂蛋白B、非HDL-C)。III期临床试验结果表明,西格列他扎没有贝特类药物和吡格列酮的传统副作用。西格列他扎未来的临床试验将进一步确立其在糖尿病、血脂异常及相关心血管风险管理中的地位。