Policosanol, an aliphatic alcohol sugarcane derivative: use in patients intolerant of or inadequately responsive to statin therapy

Abstract

Policosanol is a compound derived from sugarcane wax with low-density-lipoprotein (LDL) cholesterol-lowering properties. The aim of this study is to evaluate the effect of Policosanol on LDL cholesterol reduction in patients intolerant of statin therapy or on concomitant statin therapy but not at target LDL cholesterol levels. Twenty-one patients treated with policosanol 10 mg twice a day for 156 ± 63 days were analyzed retrospectively. Pre-and posttreatment fasting lipid profiles were collected and statistical analysis was performed as paired t-tests. Data were further analyzed into subgroups based on the presence or absence of statin therapy. In the 21 patients, LDL cholesterol decreased by 17% (p < 0.001) and total cholesterol decreased by 9.4% (p < 0.001). No significant changes were seen in high-density-lipoprotein (HDL) cholesterol or triglyceride levels. In the 6 patients treated with a statin and Policosanol, there was also a 17% LDL cholesterol reduction (p = 0.005). In the 15 patients treated only with Policosanol, LDL cholesterol was also decreased by 17% (p = 0.003). Policosanol use was observed to be associated with a mild-to-moderate (17%) decrease in LDL cholesterol. This association was observed in patients intolerant of statin therapy and in those receiving adjunctive Policosanol with statin therapy.

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“…Failure to show benefit in reducing blood lipids has been reported elsewhere in Europe (Berthold et al 2006). However, in a nonplacebo-controlled study using policosanol on patients (i) not at their LDL target on maximum statin doses or (ii) on combination therapy, policosanol reportedly showed a statistically significant (17%) reduction in LDL in each of these 2 groups (Wright et al 2004). Policosanol appears promising, but it must be tested further in a large-scale multicenter, multiethnic, clinical trial throughout several countries in at least Europe, North America, and Latin America.…”

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“…Эффективность поликозанола у пациентов с гиперхолестеринемией II типа и сопутствующими нарушениями функции печени соответствует результатам применения препарата у лиц с гиперхолестеринемией без нарушения функции печени [25]. При приёме поликозанола пациентами наблюдалось снижение уровня ОХС (на -13,6 %), ХС ЛПНП (на -19,1 %), соотношения уровня ХС ЛПНП/ ХС ЛПВП (на -25,5 %) и повышение уровня ХС ЛПВП (на +11,5 %).…”

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“…The study results led to the conclusion that policosanol over the 12‐week study period in usual doses (10–20 mg/day) and high doses (40–80 mg/day) did not affect any significant reduction in blood lipids. Wright et al in a nonplacebo controlled study using a sugarcane formulation of policosanol (10 mg twice daily) obtained in the United States found a statistically significant 17% reduction in LDL in each of two groups [94]. These groups were patients intolerant of therapy with any statin and patients not at their LDL target on maximum statin doses as well as combination therapy.…”

“…Therefore, whereas additional safe adjunctive lipid‐lowering therapy such as policosanol appears important for many patients, the study of Berthold et al [93] raises the concern of lack of effectiveness and the study of Wright et al [94] shows value and safety but not nearly to the degree of effectiveness reported from Cuba. What are the explanations for the contrasting results?…”