GPR109A agonist
- Suppresses adipocyte lipolysis → altered lipid handling
- Prostaglandin release through the same receptor causes the flushing
- Raises HDL and lowers triglycerides
Drugs with this mechanism (3)
- Dimethyl fumarate — Oral MS drug acting through Nrf2; flushing and lymphopenia are the limiting effects.
- Diroximel fumarate — Dimethyl fumarate reformulated for less GI upset; same active metabolite.
- Niacin — Vitamin B3; NAD precursor and lipid agent, causes GPR109A-mediated flushing.
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