Cardiovascular Diabetology (Jun 2019)

The selective peroxisome proliferator-activated receptor alpha modulator (SPPARMα) paradigm: conceptual framework and therapeutic potential

  • Jean-Charles Fruchart,
  • Raul D. Santos,
  • Carlos Aguilar-Salinas,
  • Masanori Aikawa,
  • Khalid Al Rasadi,
  • Pierre Amarenco,
  • Philip J. Barter,
  • Richard Ceska,
  • Alberto Corsini,
  • Jean-Pierre Després,
  • Patrick Duriez,
  • Robert H. Eckel,
  • Marat V. Ezhov,
  • Michel Farnier,
  • Henry N. Ginsberg,
  • Michel P. Hermans,
  • Shun Ishibashi,
  • Fredrik Karpe,
  • Tatsuhiko Kodama,
  • Wolfgang Koenig,
  • Michel Krempf,
  • Soo Lim,
  • Alberto J. Lorenzatti,
  • Ruth McPherson,
  • Jesus Millan Nuñez-Cortes,
  • Børge G. Nordestgaard,
  • Hisao Ogawa,
  • Chris J. Packard,
  • Jorge Plutzky,
  • Carlos I. Ponte-Negretti,
  • Aruna Pradhan,
  • Kausik K. Ray,
  • Željko Reiner,
  • Paul M. Ridker,
  • Massimiliano Ruscica,
  • Shaukat Sadikot,
  • Hitoshi Shimano,
  • Piyamitr Sritara,
  • Jane K. Stock,
  • Ta-Chen Su,
  • Andrey V. Susekov,
  • André Tartar,
  • Marja-Riitta Taskinen,
  • Alexander Tenenbaum,
  • Lale S. Tokgözoğlu,
  • Brian Tomlinson,
  • Anne Tybjærg-Hansen,
  • Paul Valensi,
  • Michal Vrablík,
  • Walter Wahli,
  • Gerald F. Watts,
  • Shizuya Yamashita,
  • Koutaro Yokote,
  • Alberto Zambon,
  • Peter Libby

DOI
https://doi.org/10.1186/s12933-019-0864-7
Journal volume & issue
Vol. 18, no. 1
pp. 1 – 20

Abstract

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Abstract In the era of precision medicine, treatments that target specific modifiable characteristics of high-risk patients have the potential to lower further the residual risk of atherosclerotic cardiovascular events. Correction of atherogenic dyslipidemia, however, remains a major unmet clinical need. Elevated plasma triglycerides, with or without low levels of high-density lipoprotein cholesterol (HDL-C), offer a key modifiable component of this common dyslipidemia, especially in insulin resistant conditions such as type 2 diabetes mellitus. The development of selective peroxisome proliferator-activated receptor alpha modulators (SPPARMα) offers an approach to address this treatment gap. This Joint Consensus Panel appraised evidence for the first SPPARMα agonist and concluded that this agent represents a novel therapeutic class, distinct from fibrates, based on pharmacological activity, and, importantly, a safe hepatic and renal profile. The ongoing PROMINENT cardiovascular outcomes trial is testing in 10,000 patients with type 2 diabetes mellitus, elevated triglycerides, and low levels of HDL-C whether treatment with this SPPARMα agonist safely reduces residual cardiovascular risk.

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