Bezafibrate

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Bezafibrate
Bezafibrate.svg
Systematic (IUPAC) name
2-(4-{2-[(4-chlorobenzoyl)amino]ethyl}phenoxy)-2-methylpropanoic acid
Clinical data
AHFS/Drugs.com International Drug Names
MedlinePlus a682711
Legal status
Routes Oral
Identifiers
CAS number 41859-67-0 YesY
ATC code C10AB02
PubChem CID 39042
IUPHAR ligand 2668
DrugBank DB01393
ChemSpider 35728 YesY
UNII Y9449Q51XH YesY
KEGG D01366 YesY
ChEBI CHEBI:47612 YesY
ChEMBL CHEMBL264374 YesY
Chemical data
Formula C19H20ClNO4 
Mol. mass 361.819 g/mol
 YesY (what is this?)  (verify)

Bezafibrate (marketed as Bezalip and various other brand names) is a fibrate drug used for the treatment of hyperlipidaemia. It helps to lower LDL cholesterol and triglyceride in the blood, and increase HDL.

History[edit]

Bezafibrate was first introduced by Boehringer Mannheim in 1977.

Mode of action[edit]

Like the other fibrates, bezafibrate is an agonist of PPARα; some studies suggest it may have some activity on PPARγ and PPARδ as well.

Uses[edit]

Bezafibrate improves markers of combined hyperlipidemia, effectively reducing LDL and triglycerides and improving HDL levels.[1] The main effect on cardiovascular morbidity is in patients with the metabolic syndrome, the features of which are attenuated by bezafibrate.[2] Studies show that in patients with impaired glucose tolerance, bezafibrate may delay progress to diabetes,[3] and in those with insulin resistance it slowed progress in the HOMA severity marker.[4] In addition, a prospective observational study of dyslipidemic patients with diabetes or hyperglycemia showed that bezafibrate significantly reduces haemoglobin A1c (HbA1c) concentration as a function of baseline HbA1c levels, regardless of concurrent use of antidiabetic drugs.[5]

Side-effects[edit]

The main toxicity is hepatic (abnormal liver enzymes), and myopathy and rarely rhabdomyolysis have been reported.

Other uses[edit]

The Australian biotech company Giaconda combines bezafibrate with chenodeoxycholic acid in an anti-hepatitis C drug combination called Hepaconda.

Bezafibrate has been shown to reduce tau protein hyperphosphorylation and other signs of tauopathy in transgenic mice having human tau mutation.[6]

References[edit]

  1. ^ "Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease: the Bezafibrate Infarction Prevention (BIP) study". Circulation 102 (1): 21–7. 2000. doi:10.1161/01.cir.102.1.21. PMID 10880410. 
  2. ^ Tenenbaum, A; Motro, M; Fisman, EZ; Tanne, D; Boyko, V; Behar, S (2005). "Bezafibrate for the secondary prevention of myocardial infarction in patients with metabolic syndrome". Archives of Internal Medicine 165 (10): 1154–60. doi:10.1001/archinte.165.10.1154. PMID 15911729. 
  3. ^ Tenenbaum, A; Motro, M; Fisman, EZ; Schwammenthal, E; Adler, Y; Goldenberg, I; Leor, J; Boyko, V et al. (2004). "Peroxisome proliferator-activated receptor ligand bezafibrate for prevention of type 2 diabetes mellitus in patients with coronary artery disease". Circulation 109 (18): 2197–202. doi:10.1161/01.CIR.0000126824.12785.B6. PMID 15123532. 
  4. ^ Tenenbaum, A; Fisman, EZ; Boyko, V; Benderly, M; Tanne, D; Haim, M; Matas, Z; Motro, M; Behar, S (2006). "Attenuation of progression of insulin resistance in patients with coronary artery disease by bezafibrate". Archives of Internal Medicine 166 (7): 737–41. doi:10.1001/archinte.166.7.737. PMID 16606809. 
  5. ^ Teramoto T, Shirai K, Daida H, Yamada N. Effects of bezafibrate on lipid and glucose metabolism in dyslipidemic patients with diabetes: the J-BENEFIT study. Cardiovascular Diabetology 2012, 11:29. http://www.cardiab.com/content/11/1/29, PMID 22439599
  6. ^ Dumont M, Stack C, Elipenahli C, Jainuddin S, Gerges M, Starkova N, Calingasan NY, Yang L, Tampellini D, Starkov AA, Chan RB, Di Paolo G, Pujol A, Beal MF (2012). "Bezafibrate administration improves behavioral deficits and tau pathology in P301S mice". Human Molecular Genetics 21 (23): 5091–5105. doi:10.1093/hmg/dds355. PMID 22922230.