New drug reduces triglyceride by 25%, but cannot lower heart disease risk in type 2 diabetes

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Triglycerides are fatty substances in the blood.

High triglyceride levels can increase the risk of heart disease, especially in conjunction with too much “bad” cholesterol, or low-density lipoprotein (LDL), and too little “good” cholesterol, or high-density lipoprotein (HDL).

In a study from Harvard University, scientists found a new medication, pemafibrate, lowered triglyceride levels among adults with type 2 diabetes yet did not decrease their heart disease risk.

They examined the effects of pemafibrate, a novel medication designed to lower triglycerides and increase HDL levels.

Between March 2017 and September 2020, the team tested nearly 10,500 adults with high triglycerides, low HDL and type 2 diabetes enrolled in the study in 24 countries, with one-fifth of participants in the U.S.

They were assigned to receive pemafibrate or placebo for three years, on average.

The average age of participants was 64 years. Nearly all were taking a statin to lower cholesterol. At the time of the study, half of the participants had type 2 diabetes for more than 10 years.

After three years, the team found pemafibrate reduced triglyceride levels by 26% compared to placebo. However, the medication did not appear to reduce the risk of heart disease.

Approximately 1 out of 10 study participants—in both groups—had a heart attack, stroke, blocked arteries that required treatment or died from cardiovascular disease within three years.

The medication was also linked to an increase in LDL cholesterol during the trials.

The team says this medication class is the second most commonly used group, after statins, to lower lipid levels and while the medication did not increase CVD risk.

The study raises new questions about the best way to treat patients with type 2 diabetes and hypertriglyceridemia who continue to experience a high rate of cardiovascular events—1 in 10 by 3 years despite being on statin therapy and having fairly good control of LDL.

The study had several limitations: the medication did not lower triglycerides or increase HDL levels as much as expected, potentially due to the high proportion of statin use, and Black adults were underrepresented in the study.

If you care about heart health, please read studies about a new cause of heart disease, and Aspirin is linked to increased risk of heart failure.

For more information about heart health, please see recent studies about simple exercise that could strongly benefit people with heart problems, and results showing the best time to take vitamins to prevent heart disease.

The study was conducted by Aruna D. Pradhan et al and presented at the American Heart Association’s Scientific Sessions 2022.

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