Effects of the new dual PPAR alpha/delta agonist GFT505 on lipid and glucose homeostasis in abdominally obese patients with combined dyslipidemia or impaired glucose metabolism.

摘要

OBJECTIVE: We evaluated the metabolic effects and tolerability of GFT505, a novel dual peroxisome proliferator-activated receptor alpha/delta agonist, in abdominally obese patients with either combined dyslipidemia or prediabetes. RESEARCH DESIGN AND METHODS: The S1 study was conducted in 94 patients with combined dyslipidemia while the S2 study was conducted in 47 patients with prediabetes. Participants were randomly assigned in a double-blind manner to GFT505 at 80 mg/day or placebo for 28 (S1) or 35 (S2) days. Primary efficacy end points were changes from baseline at week 4 in both fasting plasma triglycerides and HDL cholesterol in the S1 group and 2-h glucose upon oral glucose tolerance test in the S2 group. RESULTS: In comparison with placebo, GFT505 significantly reduced fasting plasma triglycerides (S1: least squares means -16.7% [95% one-sided CI -infinity to -5.3], P = 0.005; S2: -24.8% [-infinity to -10.5], P = 0.0003) and increased HDL cholesterol (S1: 7.8% [3.0 to infinity], P = 0.004; S2: 9.3% [1.7 to infinity], P = 0.009) in both studies, whereas LDL cholesterol only decreased in S2 (-11.0% [ -infinity to -3.5], P = 0.002). In S2, GFT505 did not reduce 2-h glucose (-0.52 mmol/L [-infinity to 0.61], P = 0.18) but led to a significant decrease of homeostasis model assessment of insulin resistance (-31.4% [-infinity to 12.5], P = 0.001), fasting plasma glucose (-0.37 mmol/L [-infinity to -0.10], P = 0.01) and fructosamine (-3.6% [-infinity to -0.20], P = 0.02). GFT505 also reduced gamma glutamyl transferase levels in both studies (S1: -19.9% [-infinity to -12.8], P < 0.0001; S2: -15.1% [-infinity to -1.1], P = 0.004). No specific adverse safety signals were reported during the studies. CONCLUSIONS: GFT505 may be considered a new drug candidate for the treatment of lipid and glucose disorders associated with the metabolic syndrome.