Effect of polyenyl phosphatidyl choline on clofibrate-induced increase in LDL cholesterol

Abstract

In a double-blind, randomised, cross-over trial clofibrate and a combination of polyenyl phosphatidyl choline (PPC) plus clofibrate were tested in 67 patients with hyperlipoproteinemia. Each treatment lasted for 4 weeks and was separated by a 4 week placebo period. The daily doses were clofibrate 1.2 g and PPC 1.8 g + clofibrate 1.2 g. respectively. The results revealed that polypenyl phosphatidyl choline prevented the elevation of LDL-cholesterol induced by clofibrate treatment, and that the lipid-lowering potency of the combination did not differ significantly from that of clofibrate. Since elevation of LDL-cholesterol is considered to increase the risk of coronary heart disease, the combination appears to offer a therapeutic advantage. Despite the significance of this clinical observation, a final decision may only be obtained from a prospective, long term investigation in patients with coronary heart diseases and hyperlipoproteinemia.

Efficacy and safety of high-density lipoprotein cholesterol-increasing compounds

“…For the 30 trials with niacin, the distribution is as follows: 11 trials with immediate-release niacin (IR-niacin) (54,64 -73), 10 trials with acipimox (72,74 -82), 6 trials with extended-release niacin (ER-niacin) (67,(83)(84)(85)(86)(87), and 5 trials with wax-matrix sustained-release niacin (SR-niacin) (64,88 -91). From the 83 trials, 6 trials (21,22,54,64,67,72) used multiple treatment arms with more than one fibric acid or nicotinic acid derivative, and 15 trials had different study populations (26,28,31,33,38,44,49,51,53,58,62,68,74,75,81). Overall, in these studies 16,802 subjects were treated with fibrates or placebo, and 4,749 subjects were treated with niacin or placebo.…”

“…The body mass index of patients in trials with fibrates and niacin was 27 and 28 kg/m 2 , respectively. Twelve trials used random assignment with a crossover design (19,21,26,27,38,40,42,45,51,57,58,61). Subjects with the following dyslipidemias and study populations were enrolled into the 83 trials: 29 trials with hypercholesterolemia (5,(22)(23)(24)(25)28,33,34,36,43,49,52,53,(55)(56)(57)59,60,62,64,67,(85)(86)(87)(88)(89)(90)92); 25 trials with type II diabetes mellitus (15,17,18,20,29,31,32,37-39,41,43,44,46,50,57,65,68,76 -79,81-83); 16 trials with combined hyperlipidemia (21,27,28,33,38,44,…”