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[Effectiveness of ciprofibrate. Open study in a Portuguese population]
J M Silva1, M C Branco, M Pereira
1Hospitais da Universidade de Coimbra (H.U.C.), Serviço de Medicina II.
Study Objective:
To determine the efficacy of ciprofibrate in portuguese patients with hypercholesterolaemia, hypertriglyceridaemia and mixed hyperlipidaemia.
Design:
Open-label study with 6-month therapy.
Setting:
Out-patient clinics of two Central Hospitals.
Participants:
Sequential sample of 40 patients 20 from each hospital. 37 patients (92.5%) completed the study; 14 had dyslipidaemia type IIa, 12 type IIb and 11 type IV.
Methods:
After at least one month of diet or washout period, all participants were given 100 mg/day of ciprofibrate, taken after the evening meal. Analysis and clinical examinations were performed at weeks (-4), (0), (+8), (+16) and (+24). Total (TC) and HDL (HDL-C) cholesterol, triglycerides (TG), apoproteins A-I, B100, and (a), and fibrinogen were determined. LDL-cholesterol (LDL-C) was calculated by means of the Friedewald formula, whenever TG < or = 400 mg/dl.
Main Results:
With ciprofibrate, in the whole population, TC, TG, LDL-C, apoB100, and TC/HDL-C ratio diminished, respectively 16.6%, 46.2%, 20.7%, 12.6% and 24.6%. HDL-C and apoA-I increased 10.4% and 4.2%. LDL-C was reduced by 29.5% (p = 0.0001) in type IIa patients, and increased 23% (not statistically significant) in type IV patients. The reduction of TG attained 57.4% in type IIb patients. One type IIb patient received 200 mg/day of the drug from week (+16) on. BMI, waist/hip ratio, hypertension, alcohol consumption and sex didn't affect ciprofibrate activity.
Conclusions:
These results confirm the high efficacy of ciprofibrate in patients with hypercholesterolaemia, hypertriglyceridaemia and mixed hyperlipidaemia. In type IIa dyslipidaemia, the reduction of LDL-C was roughly equivalent to that of the less potent statins. In type IV dyslipidaemia LDL-C may increase moderately. The influence on apoprotein (a) and fibrinogen was positive but modest.