Effect of pemafibrate on LDL ‐cholesterol properties in type 2 diabetes and hypertriglyceridemia by lipid management status: PARM ‐

ABSTRACT

Although pemafibrate attracts attention for reducing LDL‐C in patients with high baseline LDL‐C, its comprehensive effects remain unclear in patients with type 2 diabetes. This post hoc analysis of the PARM‐T2D study investigated the effects of pemafibrate on LDL‐C concentration and particle size in 156 subjects with type 2 diabetes and hypertriglyceridemia, categorized by baseline LDL‐C levels. While triglycerides and remnant lipoprotein cholesterol significantly improved across all groups over 52 weeks, the impact on LDL‐C was multifaceted and dependent on baseline status. In participants with low baseline LDL‐C, concentrations increased without a rise in ApoB, suggesting an improvement in particle size. Conversely, in those with high baseline LDL‐C, both LDL‐C and ApoB decreased, reflecting favorable modifications according to baseline LDL‐C control status. These findings suggest that pemafibrate exerts beneficial, status‐dependent effects on LDL‐C properties, potentially reducing cardiovascular risk by improving LDL particle quality and quantity in high‐risk patients with diabetes.