Ciprol (ciprofibrate) / Sanofi - LARVOL DELTA

Fibrates as an Adjunct Therapy in Primary Biliary Cholangitis: A Propensity-Matched Analysis of Major Adverse Cardiovascular Events (ACG 2025) - "Cohort A was also prescribed an additional fibrate (fenofibrate, gemfibrozil, bezafibrate, or ciprofibrate); Cohort B received UDCA monotherapy. The fibrate cohort had higher baseline total cholesterol (212.7 ± 90.0 vs 191.5 ± 66.7 mg/dL, p 0.05). Over a five-year period, fibrate and UCDA-only patients did not differ in the incidence of MACE (HR 1.09, 0.91-1.29, p = 0.35), no individual MACE components (all p-values > 0.05) , or all-cause mortality (HR 0.92, 0.73-1.16, p = 0.47). In this large U.S. real-world cohort, adding a fibrate to UDCA did not significantly increase MACE or mortality despite a more atherogenic lipid profile at baseline. The modest, nonsignificant excess in event rates likely reflects residual confounding from patients selected for fibrate therapy because of dyslipidemia."

Adverse events • Cardiovascular • CNS Disorders • Congestive Heart Failure • Coronary Artery Disease • Diabetes • Dyslipidemia • Heart Failure • Hepatology • Hypertension • Immunology • Metabolic Disorders • Myocardial Infarction • Primary Biliary Cholangitis

Fibrates as an Adjunct Therapy in Primary Biliary Cholangitis Is Associated With Lower Hospitalization and Healthcare Utilization: A Propensity-Matched Analysis (ACG 2025) - "Introduction: Fibrates is considered a second line agent for primary biliary cholangitis (PBC) and improves biochemical responses in PBC patients not responding to ursodeoxycholic acid (UDCA)...Cohort A was also prescribed additional fibrate (fenofibrate, gemfibrozil, bezafibrate, or ciprofibrate); Cohort B was on UDCA monotherapy... Over five years, fibrate patients were less likely to develop spontaneous bacterial peritonitis (2.0 % vs. 1.1%, HR 0.52, 0.29-0.92), and had fewer incidences of all-cause hospitalizations ( 26.7 % vs. 21.8%, HR 0.75, 0.65-0.86)."

Clinical • HEOR • CNS Disorders • Fatigue • Fibrosis • Hepatic Encephalopathy • Hepatocellular Cancer • Hepatology • Immunology • Musculoskeletal Diseases • Osteoporosis • Primary Biliary Cholangitis • Rheumatology • Solid Tumor

Visible-Light-Induced Monofluoromethylation of Styrenes. (PubMed, Org Lett) - "This approach enables the direct fluoroalkylation of alkenes, affording the desired allylic monofluoromethyl products with high efficiency. The reaction proceeds under mild conditions and exhibits a broad substrate scope, displaying excellent functional group tolerance across various biologically important molecules, including derivatives of estrone, thymol, amino acids, glucose, and ciprofibrate."

Journal

TREATMENT OUTCOMES AND UNDERUTILIZATION OF SECOND-LINE THERAPIES FOR PRIMARY BILIARY CHOLANGITIS IN LATIN AMERICA: A CALL TO BRIDGE THE GAP (AASLD 2025) - "Background: Approximately 40% of patients with primary biliary cholangitis (PBC) exhibit an incomplete biochemical response to ursodeoxycholic acid (UDCA) and require add-on therapy...Fibrates (bezafibrate, fenofibrate or ciprofibrate) were used in 28.8%, mostly for incomplete response (67.4%) and pruritus (15.4%)... Response to UDCA as first line PBC therapy was lower than expected. Second-line therapies remain underused in Latin America, highlighting a critical gap evidence-based recommendations and real-world clinical practice in the region. Addressing this gap requires urgent action from healthcare systems, prioritizing physician awareness, the implementation of targeted educational initiatives, and expanded access to second-line therapies to improve patient outcomes."

Clinical • Autoimmune Hepatitis • Dermatology • Fibrosis • Hepatology • Immunology • Inflammation • Primary Biliary Cholangitis • Pruritus

Development of Ciprofibrate Platinum(IV) Nanodrugs as Antimetastatic Agents with COFs as Carriers. (PubMed, J Med Chem) - "The nanodrug effectively reversed the epithelial-mesenchymal transition by inhibiting the PI3K/AKT/mTOR pathway and reversing the hypoxic microenvironment. Furthermore, antitumor immunity was enhanced by elevating the density of CD3+ and CD8+ T cells and triggering macrophage polarization from the M2 to M1 phenotype in tumors."

IO biomarker • Journal • Oncology • ABCA1 • ACAT1 • BCL2 • CASP3 • CD8 • H2AX • PPARA

Developmental Patterns of Hepatic Peroxisome Proliferator-Activated Receptor (PPAR) Expression in Xenopus laevis and Response to Pharmaceutical Agonists During Metamorphic Climax. (PubMed, J Exp Zool A Ecol Integr Physiol) - "We conducted two experiments to elucidate (a) the expression in late metamorphosis for xPPARα/β/γ subtypes, and (b) the effect of pharmaceutical PPAR agonists (pirinixic acid, bezafibrate, and ciprofibrate) on the expression of xPPARα/β/γ target genes. However, pharmaceuticals identified to interact with xPPARα/β/γ did not elicit a response concordant with PPAR agonism at high doses. These results suggest that X. laevis may not be a sensitive model for studies testing PPAR-mediated effects of xenobiotics."

Journal • Metabolic Disorders • PPARA

STaRT: Lipoprotein(a) Levels in Patients With Atherosclerotic Cardiovascular Diseases in Russia (clinicaltrials.gov) - P=N/A | N=2382 | Recruiting | Sponsor: Novartis Pharmaceuticals | Not yet recruiting ➔ Recruiting

Enrollment open • Atherosclerosis • Cardiovascular

Screening and Identification of Entry Inhibitors for HBV Infection (APASL 2025) - "By adding these small molecule compounds at different time points during the HBV infection of HepG2-NTCP cells, we found that isotretinoin (ISO), ciprofibrate (CIP), and caffeic acid (CAF) reduced HBV infection efficiency and inhibited HBV expression when treated concurrently with HBV infection. In conclusion, our research results suggest that ISO, CIP and CAF are prospective candidate agents for anti-HBV and HDV targeting L-HBsAg directly. These compounds contribute to the development of a well-tolerated and broadly active inhibitor of viral infection. Table and Figure:Figure 1.Screening of small molecule compounds binding with L-HBsAg Figure 2.Identification of Entry Inhibitors for HBV Infection"

Hepatitis B • Hepatology • Infectious Disease • Inflammation

STaRT: Lipoprotein(a) Levels in Patients With Atherosclerotic Cardiovascular Diseases in Russia (clinicaltrials.gov) - P=N/A | N=2382 | Not yet recruiting | Sponsor: Novartis Pharmaceuticals

New trial • Atherosclerosis • Cardiovascular

A new ciprofibrate calcium salt with improved solubility and intrinsic dissolution rate. (PubMed, J Pharm Sci) - "Ca(CIP)2.H2O exhibited higher solubility and dissolution rate than CIP-free form and was stable up to 6 months at 40°C (75%RH). Therefore, Ca(CIP)2.H2O may be a viable alternative for use in solid dosage forms."

Journal

Identification and validation of platelet-related diagnostic markers and potential drug screening in ischemic stroke by integrating comprehensive bioinformatics analysis and machine learning. (PubMed, Front Immunol) - "The drugs alpha-linolenic acid and ciprofibrate have potential antiplatelet effects in IS. This study advances early IS diagnosis and treatment."

Biomarker • Journal • Machine learning • Preclinical • Cardiovascular • Hematological Disorders • Ischemic stroke • Thrombosis • CD4 • CD8 • F13A1 • PPBP • THBS1

Electrochemical N-Aroylation of Sulfoximines using Benzoyl Hydrazines with H2 Generation. (PubMed, Chemistry) - "The strategy is applied to late-stage sulfoximidation of L-menthol, (-)-borneol, D-glucose, vitamin-E derivatives, and marketed drugs such as probenecid, ibuprofen, flurbiprofen, ciprofibrate, and sulindac. In addition, the present methodology is mild, high functional group tolerance with broad substrate scope and scalable."

Journal

REAL-WORLD EXPERIENCE WITH FIBRATES IN PATIENTS WITH PRIMARY BILIARY CHOLANGITIS (AASLD 2023) - " In total, 318 patients (female n=291; 91.5%) with PBC who initiated fibrates during follow up were included, of which 4 (1.2%) did not use ursodeoxycholic acid. Fibrates of use were bezafibrate (n=311; 97.8%), ciprofibrate (n=5; 1.6%) and gemfibrozil (n=2; 0.6%)... In this nation-wide real-world study, fibrate use was associated with statistically significant reductions in cholestatic surrogate markers after one year of therapy, with about a third of patients reaching the most stringent biochemical treatment goals. However, discontinuation rate was high, indicating the need to optimize fibrate treatment strategies."

Clinical • Real-world • Real-world evidence • Fibrosis • Hepatology • Immunology • Primary Biliary Cholangitis

The tissue-specific metabolic effects of the PPARα agonist ciprofibrate in insulin-resistant male individuals: a double-blind, randomized, placebo-controlled crossover study. (PubMed, Obesity (Silver Spring)) - "Ciprofibrate treatment increased hepatic lipid accumulation and lowered MRgluc, without affecting whole-body insulin sensitivity. Furthermore, parameters of cardiac function or cardiac energy status were not altered upon ciprofibrate treatment."

Journal • Cardiovascular • Hepatology • Non-alcoholic Fatty Liver Disease • PPARA

HPTLC-Bioluminescent Bioautography Screening of Herbal Teas for Adulteration with Hypolipidemic Drugs. (PubMed, Biosensors (Basel)) - "By coupling bioluminescent bioautography with high performance thin-layer chromatography (HPTLC), we developed a facile method suitable for screening hypolipidemic drugs (ciprofibrate and bezafibrate) adulteration in five different herbal teas (lotus leaf, Apocynum, Ginkgo biloba, Gynostemia and chrysanthemum). Furthermore, the optimized method was performed with artificially adulterated samples and the recovery rates were determined to be within the range of 71% to 91%, bracing its practical reliability. Showing superiorly high simplicity, throughput and specificity, this work demonstrated that the analytical method jointly based on HPTLC and bioautography was an ideal tool for screening bioactive compounds in complex biological matrix."

Journal • Dyslipidemia

Fibrates for the Treatment of Primary Biliary Cholangitis Unresponsive to Ursodeoxycholic Acid: An Exploratory Study. (PubMed, Front Pharmacol) - "Aim: Up to 40% of patients with primary biliary cholangitis (PBC) will have a suboptimal biochemical response to ursodeoxycholic acid (UDCA), which can be improved by the addition of fibrates. Our findings endorse the efficacy of fibrate add-on treatment in PBC patients with suboptimal response to UDCA. Ciprofibrate appears to be at least as effective as bezafibrate and should be assessed in large clinical trials as a possibly new, cheaper, and promising option for treatment of UDCA-unresponsive PBC patients."

Journal • Cholestasis • Hepatology • Immunology • Primary Biliary Cholangitis

"Our study accessing ciprofibrate in unresponsive PBC! Promising drug, similar response rate to bezafibrate, lower costs. @PBCFoundation @DrCynthiaLevy @pauloplbbr @PBC_Canada @FrontPharmacol @LiverFellow @PBCers" (@gui_cancado)

[VIRTUAL] RESPONSE TO URSODEOXYCHOLIC ACID SHOULD BE ASSESSED EARLIER TO ALLOW ADD-ON SECOND-LINE THERAPY IN PATIENTS WITH PRIMARY BILIARY CHOLANGITIS UNRESPONSIVE TO INITIAL TREATMENT (AASLD 2021) - "Background: Patients with incomplete response to ursodeoxycholic acid (UDCA) at 1-year may respond to add-on therapy with either obeticholic acid or fibrate...Fifty-nine patients with inadequate response to UDCA received add-on fibrates, either bezafibrate, fenofibrate or ciprofibrate... After 6 months of treatment with UDCA, the absence of response by Toronto or Rotterdam criteria can properly identify patients who could benefit from early addition of second-line therapy . On the other hand, real life treatment response to fibrates seems to be slower and may take up to two years. A significant heterogenity was observed between different validated response criteria ."

Clinical • Cholestasis • Fibrosis • Hepatology • Immunology • Primary Biliary Cholangitis

Clinical features and treatment outcomes of primary biliary cholangitis in a highly admixed population. (PubMed, Ann Hepatol) - "Clinical features of PBC in highly admixed Brazilians were similar to those reported in Caucasians and Asians, but with inferior rates of overlap syndrome with AIH. Response to UDCA was lower than expected and inversely associated with histological stage and baseline AST and ALP levels. Most of patients benefited from add-on fibrates, including ciprofibrate. A huge heterogeneity in response to UDCA therapy according to available international criteria was observed and reinforces the need of global standardization."

Clinical • Journal • Cholestasis • Fibrosis • Hepatology • Immunology • Inflammation • Primary Biliary Cholangitis • Transplantation

[VIRTUAL] Ciprofibrate decreases net hepatic glucose uptake and tends to decrease net myocardial glucose uptake in prediabetic male volunteers (EASD 2021) - P3 | "This study indicates that 5 weeks of treatment with the PPARα ligand ciprofibrate decreases insulin-stimulated glucose uptake in the liver, with a similar tendency in the heart. The increase in liver fat was not associated with a decline in whole body insulin sensitivity, nor with reduced cardiac function parameters or cardiac energy status."

Metabolic Disorders • Type 2 Diabetes Mellitus • MRI • PPARA

Ciprofibrate-Loaded Nanoparticles Prepared by Nanoprecipitation: Synthesis, Characterization, and Drug Release. (PubMed, Polymers (Basel)) - "For Pluronic nanoparticles, we scanned different conditions for the CIP loading, and its encapsulation efficiency was reduced while the drug content increased in the nanoprecipitation protocol. We also performed in vitro release experiments; results demonstrate that probe release is driven by Fickian diffusion for the Pluronic NPs and a zero-order model for PEO-b-PCL NPs."

Journal • Dyslipidemia • Metabolic Disorders

[VIRTUAL] RARE XANTHOMATOSIS IN HYPERLIPIDEMIA CASE (ACC 2021) - "The most significant aspect was the unusual extensive xanthomatosis, rarely seen in phenotype IIb, what underlines the necessity of correct diagnosis and handling of such cases precociously by specialized services, so therapy can be effective and clinical complications are reduced."

Clinical • Dyslipidemia • Hematological Disorders • Hypertriglyceridemia • Metabolic Disorders • Pain • Pancreatitis

Precision medicine for mood disorders: objective assessment, risk prediction, pharmacogenomics, and repurposed drugs. (PubMed, Mol Psychiatry) - "Top drugs of interest as potential new antidepressants were pindolol, ciprofibrate, pioglitazone and adiphenine, as well as the natural compounds asiaticoside and chlorogenic acid. Finally, we provide an example of how a report to doctors would look for a patient with depression, based on the panel of top biomarkers (12 for depression and bipolar, one for mania), with an objective depression score, risk for future depression, and risk for bipolar switching, as well as personalized lists of targeted prioritized existing psychiatric medications and new potential medications. Overall, our studies provide objective assessments, targeted therapeutics, and monitoring of response to treatment, that enable precision medicine for mood disorders."

Biomarker • Journal • Alzheimer's Disease • Bipolar Disorder • CNS Disorders • Depression • Mental Retardation • Mood Disorders • Pain • Psychiatry • Suicidal Ideation • CD47 • FANCF • NRG1 • OLFM1 • PRPS1 • SMAD7

Human Peroxisomal 3-Ketoacyl-CoA Thiolase: Tissue Expression and Metabolic Regulation : Human Peroxisomal Thiolase. (PubMed, Adv Exp Med Biol) - "In the human HepG2 cells, thiolase expression is upregulated by glucose and downregulated by insulin and sterols, while dexamethasone and fatty acids have no effect. The ciprofibrate, a peroxisome proliferator, leads only to a weak stimulation of the mRNA expression as compared to thiolase B expression in the rat liver."

Journal • Gastrointestinal Cancer • Hepatocellular Cancer • Liver Cancer • Solid Tumor

Ciprofibrate and Pre-diabetes (clinicaltrials.gov) - P3; N=11; Completed; Sponsor: Maastricht University Medical Center; Recruiting ➔ Completed

Trial completion • Cardiovascular • Metabolic Disorders • FDG PET