Dose-response study of the effect of ciprofibrate on serum lipoprotein concentrations in hyperlipoproteinaemia

The effect of ciprofibrate, 2[p-(2,2-dichlorocyclopropyl)-phenoxyl]-2-methyl propionic acid, in daily doses of 50, 100, and 200 mg was studied in 50 patients with hyperlipoproteinaemia (21 type IIA, 10 type IIB and 19 type IV). Ciprofibrate was convenient to take and was without subjective side effects. The greatest hypolipidaemic effects were reached for all lipoproteins with 200 mg daily. In type IIA and IIB, mean low density lipoprotein (LDL) cholesterol was normalized on the 200 mg dose. The effect was highly dependent on initial LDL cholesterol concentrations, decreases being observed above 4 mmol/l and increases below that concentration. Mean very low density lipoprotein (VLDL) triglyceride concentrations decreased on 200 mg per day by 48-59%. HDL cholesterol increased in all types of hyperlipoproteinaemia by 6-19%, the change being unrelated to changes in VLDL lipids. With a dosage of 200 mg daily the effects were maintained for the following period of 6 months. It is concluded from this study that it would be appropriate to start patients on 100 mg daily and then titrate their dose according to response. The optimal dosage for ciprofibrate seems to be 200 mg daily.