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缓释非诺贝特片对高甘油三酯血症患者血脂异常的长期影响及安全性:一项3期、多中心、随机、开放标签、平行组研究

Long-Term Effects of Extended-Release Pemafibrate Tablets on Dyslipidemia and Safety in Triglyceridemic Patients: A Phase 3, Multicenter, Randomized, Open-Label, Parallel-Group Study.

作者信息

Arai Hidenori, Yamashita Shizuya, Araki Eiichi, Yokote Koutaro, Tanigawa Ryohei, Saito Ayumi, Furukawa Daisuke, Suganami Hideki, Ishibashi Shun

机构信息

National Center for Geriatrics and Gerontology.

Department of Cardiology, Rinku General Medical Center.

出版信息

J Atheroscler Thromb. 2025 Aug 1;32(8):1006-1026. doi: 10.5551/jat.65350. Epub 2025 Feb 7.

Abstract

AIMS

Long-term safety and efficacy of pemafibrate once-daily extended-release (XR) tablets, taken in morning or evening, were evaluated in dyslipidemic patients with high triglycerides (TG).

METHODS

In this multicenter, randomized, open-label, parallel-group, phase 3 long-term study, dyslipidemic patients with high TG were randomly assigned to morning or evening administration of XR for 52 weeks. The dose was started at 0.2 mg/day and increased to 0.4 mg/day for patients having fasting serum TG ≥ 150mg/dL during treatment. The primary efficacy endpoint was percent change in fasting serum TG.

RESULTS

The study enrolled 121 patients, assigning 61 to morning and 60 to evening administration. The study population included 71.1% males. Mean age was 58.5±11.1 (mean±SD) years, body mass index 27.7±4.3 kg/m, and fasting TG 264.0±109.2 mg/dL. Fasting serum TG decreased significantly from baseline to 52 weeks among patients overall and in the morning and evening groups (-45.7%, -44.8%, and -46.6%, respectively, p<0.001 vs. baseline). The difference in least-squares mean between the morning and evening groups was 3.0%, not statistically significant. The dose was increased in 82 patients (44 morning and 38 evening), with 57.3% (95%CI 45.9, 68.2) achieving fasting serum TG <150 mg/dL. Adverse events occurred in 83.5% and adverse drug reactions in 19.0% but with no notable safety problems.

CONCLUSIONS

Long-term, once-daily administration of XR was effective and safe in dyslipidemic patients with high TG. XR provided favorable TG-lowering effects regardless of morning or evening administration, and the XR dose increase proved effective in patients having initially inadequate response.

摘要

目的

评估在患有高甘油三酯(TG)的血脂异常患者中,每日一次服用非诺贝特缓释(XR)片,于早晨或晚上服用的长期安全性和疗效。

方法

在这项多中心、随机、开放标签、平行组、3期长期研究中,患有高TG的血脂异常患者被随机分配至早晨或晚上服用XR,为期52周。剂量从0.2毫克/天开始,对于治疗期间空腹血清TG≥150毫克/分升的患者,剂量增加至0.4毫克/天。主要疗效终点是空腹血清TG的变化百分比。

结果

该研究纳入了121名患者,61名分配至早晨服药组,60名分配至晚上服药组。研究人群中男性占71.1%。平均年龄为58.5±11.1(平均值±标准差)岁,体重指数为27.7±4.3千克/平方米,空腹TG为264.0±109.2毫克/分升。总体患者以及早晨和晚上服药组患者的空腹血清TG从基线至52周均显著降低(分别为-45.7%、-44.8%和-46.6%,与基线相比p<0.001)。早晨和晚上服药组之间的最小二乘均值差异为3.0%,无统计学意义。82名患者(44名早晨服药,38名晚上服药)增加了剂量,其中57.3%(95%CI 45.9,68.2)的患者空腹血清TG<150毫克/分升。83.5%的患者发生不良事件,19.0%的患者发生药物不良反应,但无明显安全问题。

结论

对于患有高TG的血脂异常患者,长期每日一次服用XR是有效且安全的。无论早晨或晚上服药,XR均能提供良好的降低TG效果,并且增加XR剂量对最初反应不足的患者有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de2e/12328711/218263e08cc7/32_65350_1.jpg

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