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However, fasting and postprandial hypertriglyceridemia as well as reduced high-density lipoprotein cholesterol (HDL-C) remain as residual risk factors of atherosclerotic cardiovascular diseases (ASCVD). To treat patients with hypertriglyceridemia and\/or low HDL-C, drugs such as fibrates, nicotinic acids, and n-3 polyunsaturated fatty acids have been used. However, fibrates were demonstrated to cause side effects such as liver dysfunction and increase in creatinine levels, and thus large-scale clinical trials of fibrates have shown negative results for prevention of ASCVD. The failure could be attributed to their low selectivity and potency for binding to peroxisome proliferator-activated receptor (PPAR) \u03b1. To resolve these issues, the concept of selective PPAR\u03b1 modulator (SPPARM\u03b1) with a superior balance of efficacy and safety has been proposed and pemafibrate (K-877) has been developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Recent Findings<\/jats:title>\n                    <jats:p>Pemafibrate, one of SPPARMs\u03b1, was synthesized by Kowa Company, Ltd. for better efficiency and safety. Clinical trials in Japan have established the superiority of pemafibrate on effects on serum triglycerides (TG) reduction and HDL-C elevation as well safety. Although available fibrates showed worsening of liver and kidney function test values, pemafibrate indicated improved liver function test values and was less likely to increase serum creatinine or decrease estimated glomerular filtration rate (eGFR). Very few drug-drug interactions were observed even when used concomitantly with statins. Furthermore, pemafibrate is metabolized in the liver and excreted into the bile, while many of available fibrates are mainly excreted from the kidney. Therefore, pemafibrate can be used safely even in patients with impaired renal function since there is no significant increase in its blood concentration. A large-scale trial of pemafibrate, PROMINENT, for dyslipidemic patients with type 2 diabetes is ongoing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>Pemafibrate is one of novel SPPARMs\u03b1 and has superior benefit-risk balance compared to conventional fibrates and can be applicable for patients for whom the usage of existing fibrates is difficult such as those who are taking statins or patients with renal dysfunction. In the current review, all the recent data on pemafibrate will be summarized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11883-020-0823-5","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T01:02:50Z","timestamp":1579741370000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":182,"title":["Pemafibrate, a New Selective PPAR\u03b1 Modulator: Drug Concept and Its Clinical Applications for Dyslipidemia and Metabolic Diseases"],"prefix":"10.1007","volume":"22","author":[{"given":"Shizuya","family":"Yamashita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daisaku","family":"Masuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Matsuzawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,23]]},"reference":[{"issue":"6","key":"823_CR1","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1111\/j.1365-2125.2012.04282.x","volume":"74","author":"M Oliver","year":"2012","unstructured":"Oliver M. 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Ltd., MSD K.K., Bayer Yakuhin, Ltd., Amgen-Astellas BioPharma K.K., Sonofi K.K., Skylight Biotech Inc., East Japan Institute of Technology Co., Ltd.; clinical research funding from MSD K.K., Bayer Yakuhin, Ltd., Boehringer Ingelheim Japan, Inc., AstraZeneca Co., Takeda Pharmaceutical Co., Ltd., Astellas Pharma Inc., Mitsubishi Tanabe Pharma Co., Kyowa Medex Co., Ltd., ROHTO Pharmaceutical Co., Ltd., Fujirebio Inc.; scholarship grants from Astellas Pharma Inc., Boehringer Ingelheim Japan, Inc., MSD K.K., Bayer Yakuhin, Ltd., Takeda Pharmaceutical Co., Ltd.; and courses endowed by companies from Izumisano City and Kaizuka City. DM received a grant for joint research from Kowa Pharmaceutical Co. Ltd., Boehringer Ingelheim Japan, Inc., MSD K.K., Astra Zeneca K.K., Kyowa Medex Co., Ltd., Fujirebio Company and clinical research funding from Takeda Pharmaceutical Company Limited, Ono Pharmaceutical Co., Ltd. YM has no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest"}},{"value":"This article does not contain any studies with human or animal subjects performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and Animal Rights and Informed Consent"}}],"article-number":"5"}}