Comparative study of bezafibrate and fenofibrate in patients with primary hyperlipoproteinaemia

A study was carried out in 40 patients with primary hyperlipoproteinaemia to compare the efficacy and tolerance of bezafibrate and fenofibrate, combined with a dietary regimen, in reducing lipid levels. Patients were allocated at random to receive treatment for 4 months with either 600 mg bezafibrate or 300 mg fenofibrate per day. Efficacy of treatment was assessed from measurement before and after treatment of the levels of total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides and blood glucose. Tolerance was monitored by monthly clinical examinations and routine investigation of blood chemistry and urinalysis before and after treatment. The results indicated that bezafibrate was a more effective normolipaemic agent than fenofibrate. Whilst both drugs reduced triglyceride levels significantly, only in the bezafibrate group were they decreased to within the risk-free range. Bezafibrate also produced a significant decrease in total cholesterol and LDL-cholesterol to near the risk-free level and an increase in HDL-cholesterol. With fenofibrate, total cholesterol and LDL-cholesterol levels remained within the range necessitating treatment and HDL-cholesterol showed little if any change. Although there were decreases in alkaline phosphatase and significant decreases in gamma-glutamyl transpeptidase levels in both groups after treatment, there was a tendency for SGPT, SGOT, total bilirubin and direct bilirubin levels to increase after fenofibrate but to decrease after bezafibrate.