The Fibrates Story — A Tepid End to a PROMINENT Drug

Pemafibrate is a selective peroxisome proliferator–activated receptor α modulator that has putative greater triglyceride-lowering and high-density lipoprotein (HDL) cholesterol–raising properties than other fibrates.1 Now in the Journal, Das Pradhan et al.2 describe the results of the Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes (PROMINENT) trial. In this trial, 10,497 patients with type 2 diabetes, a triglyceride level between 200 and 499 mg per deciliter, and an HDL cholesterol level of 40 mg per deciliter or less were randomly assigned to receive 0.2-mg tablets of pemafibrate twice daily or placebo. In the PROMINENT trial, two cohorts . . .