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Muraglitazar is a non-thiazolidinedione, dual peroxisome proliferator–activated receptor (PPAR) agonist that targets both the PPAR alpha and gamma subtypes. Developed by Bristol-Myers Squibb and Merck, it was investigated for the treatment of type 2 diabetes and dyslipidemia. Muraglitazar acts as an agonist at both PPARα and PPARγ receptors, resulting in potent insulin-sensitizing effects (via PPARγ) to lower blood glucose levels, as well as significant reductions in triglycerides and increases in HDL cholesterol (via PPARα). It also modestly decreases LDL cholesterol. In addition to its metabolic effects, muraglitazar has demonstrated anti-inflammatory properties through its dual receptor activity. Despite favorable changes in glycemic control and lipid profiles during clinical trials, development was discontinued after phase III due to increased risks of cardiovascular events such as myocardial infarction, stroke, heart failure, edema, weight gain, and all-cause mortality compared with placebo or pioglitazone[1][2][3][4][5][6].
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