Aims:
To compare the efficacy of pemafibrate (PF) and fenofibrate (FF) in treating dyslipidemia.
Methods:
A comprehensive search was performed on the public database to identify relevant randomized controlled
trials (RCTs), which compared the effects of PF and FF treatment in lipid parameters among patients with
dyslipidemia. Mean difference (MD) and 95% confidence intervals (CI) were pooled for continuous outcomes,
whereas odds ratio (OR) and 95% CI were calculated for dichotomous outcomes.
Results:
Three RCTs were included with a total of 744 patients (PF=547 and FF=197). Compared with the FF
group (100mg/day), PF group (0.05 to 0.4mg/day) had a better effect on reducing triglycerides (TGs) (MD, -8.66;
95%CI, -10.91 to -6.41), very low-density lipoprotein cholesterol (VLDL-C, MD, -12.19; 95%CI, -15.37 to -
9.01), remnant lipoprotein cholesterol (MD, -13.16; 95%CI, -17.62 to -8.69), apolipoprotein-B48 (ApoB48, MD,
-12.74; 95%CI, -17.71 to -7.76) and ApoCIII (MD, -6.25; 95%CI, -11.85 to -0.64). Although a slightly LDL-Cincreasing
effect was found in PF-treated group (MD, 3.10; 95%CI, -0.12 to 6.09), the levels of HDL-C (MD,
3.59; 95%CI, 1.65 to 5.53) and ApoAI (MD, 1.60; 95%CI, 0.38 to 2.82) were significantly increased in the PF
group. However, no significant difference was found in the level of total cholesterol (MD, 0.01; 95%CI, -1.37 to -
1.39), non-HDL-C (MD, -0.06; 95%CI, -1.75 to 1.63), ApoB (MD, 0.39; 95%CI, -1.37 to 2.15) and ApoAII (MD,
3.31; 95%CI, -1.66 to 8.29) between the two groups. In addition, the incidence of total adverse events (OR, 0.68;
95%CI, 0.53 to 0.86) and adverse drug reactions (OR, 0.36; 95%CI, 0.24 to 0.54) was lower in the PF group than
that in the FF group.
Conclusions:
Pemafibrate tends to have better efficacy in treating dyslipidemia than fenofibrate.