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Abstract
The literature for the last seven years was reviewed in terms of the effect of the
various fibric acid derivatives on blood lipid and lipoprotein levels. The criteria
for review resulted in a greater focus on three of the newer fibric acid derivatives:
bezafibrate, ciprofibrate, fenofibrate. In type II A hyperlipoproteinemia, all fibric
acid derivatives produce modest reductions in total plasma cholesterol and low-density
lipoprotein cholesterol. The evidence suggests that bezafibrate, ciprofibrate, and
fenofibrate may produce greater reductions in low-density lipoprotein cholesterol
than those usually observed with clofibrate and gemfibrozil. All fibric acid derivatives
produce modest reductions in triglycerides and modest increases in high-density lipoprotein
cholesterol in type II A hyperlipoproteinemia. In type II B hyperlipoproteinemia,
the low-density lipoprotein cholesterol lowering effect of fibric acid derivatives
is generally less than that observed in type II A hyperlipoproteinemia. In type II
B hyperlipoproteinemia, there is a mean decrease in low-density lipoprotein cholesterol
for all, patients studied. However, there is a considerable interpatient variation
ranging from significant decreases to significant increases in low-density lipoprotein
cholesterol. Further studies are required to assess whether the low-density lipoprotein
cholesterol lowering effect is greater with the newer fibric acid derivatives. All
fibric acid derivatives produce clinically significant decreases in triglyceride levels
in type II B. There is also an associated increase in high-density lipoprotein cholesterol.
In type IV hyperlipoproteinemia, all fibric acid derivatives produce clinically significant
reductions in triglyceride. There is also an associated increase in high-density lipoprotein
cholesterol and generally also an increase in low-density lipoprotein cholesterol
levels. The available data do not suggest a clinically significant difference in the
hypotriglyceridemic effect of the various fibric acid derivatives in type IV hyperlipoproteinemia.
The lipid-altering effects of the various fibric acid derivatives were usually less
in those studies that contained placebo and dietary controls. Additional controlled
clinical trials are needed to accurately discriminate the relative lipid- and lipoprotein-altering
effects of the various fibric acid derivatives.
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References
- Modification of metabolism and distribution of lipids by chlorphenoxyisobutyrate.Nature. 1962; 194: 948-949
- Symposium on atromide. 5th ed. J Atheroscler Res. 3. 1962: 347-775
- Clofibrate and related analogs.Marcel Dekker, New York1972
- One-year treatment with fenofibrate (procetofen) of patients affected by primary type II hyperlipoproteinemia.in: Effect on lipoprotein lipids and biochemical tolerance. 5th ed. Curr Ther Res. 28. 1980: 728-733
- Comparison of the lipid-lowering action of bezafibrate retard and etofibrate retard in patients with type II B hyperlipoproteinaemia.in: Pharmacological control of hyperlipidaemia. JR Prous Science Publishers, Barcelona, Spain1986: 309-318
- Effect of long-term bezafibrate treatment on biliary lipid metabolism in patients with endogenous hypertriglyceridemia: with special reference to the risk of cholelithiasis.in: Fears R Pharmacological control of hyperlipidemia. JR Prous Science Publishers, Barcelona, Spain1986: 343-349
- Effect of procetofen on serum lipids and apoproteins.Int J Clin Pharmacol Ther Toxicol. 1984; 22: 194-197
- Effect of procetofen on serum total cholesterol, triglyceride, and high density lipoprotein cholesterol concentrations in hyperlipoproteinemia.Int J Clin Pharmacol Ther Toxicol. 1981; 19: 534-538
- Procetofen-eine alternative in der behandlung der hypercholesterinamia?.Schweiz Med Wochenschr. 1979; 109: 1140-1143
- Untersuchungen zur wirksamkeit von bezafibrat und fenofibrat auf erhohte lipide des blutes bei HLP typ IIa, and IIb und IV.Med Welt. 1982; 33: 51/631-61/637
- Fenofibrate therapy of hypertriglyceridaemias.in: Differential effects on LDL cholesterol level in type IV and in type II B primary hyperlipoproteinaemia. 5th ed. Eur J Clin Pharmacol. 26. 1984: 741-744
- Variations in lipids and lipoproteins by fenofibrate in some hyperlipoproteinaemic states.Atherosclerosis. 1983; 47: 95-100
- Long-term clinical experience with procetofen.Clin Ther Cardiovasc. 1982; 2: 171-175
- Effect of fenofibrate on serum lipoproteins in subjects with familial hypercholesterolemia and combined hyperlipidemia.Atherosclerosis. 1984; 53: 321-325
- Influence of procetofen on serum lipids and on adipose tissue lipoprotein lipase activity in hyperlipidemic patients.Curr Ther Res. 1983; 33: 317-321
- The effect of fenofibrate (procetofen) on the lipoprotein profile in patients affected by primary type II hyperlipoproteinemia.Curr Ther Res. 1979; 26: 350-356
- Treatment of hyperlipoproteinemia (HLP) type II A with a new phenoxyisobuturic acid derivative, procetofen.Int J Clin Pharmacol Biopharm. 1979; 17: 503-506
- Fenofibrate reduces low density lipoprotein catabolism in hypertriglyceridemic subjects.Arteriosclerosis. 1985; 5: 162-168
- Effects of fenofibrate on high and low density lipoprotein metabolism in heterozygous familial hypercholesterolemia.Atherosclerosis. 1985; : 161-169
- Fenofibrate and cholestyramine in type II hyperlipoproteinaemia.Artery. 1982; 10: 353-367
- Long-term effects of bezafibrate and of a bezafibrate and cholestyramine combination on lipids and lipoprotein lipids in type II A hypercholesterolaemic patients.Int J Pharm Res. 1986; 6: 249-253
- Comparative evaluation of the effects of ciprofibrate and fenofibrate on lipids, lipoproteins and apoproteins A and B.Atherosclerosis. 1985; 54: 273-281
- Double-blind cross-over study of the effect of sultosilic acid piperazine salt (A-585) and bezafibrate in primary hyperlipoproteinemia.Atherosclerosis. 1983; 49: 109-118
- Comparative study of once and 3-times daily regimens of bezafibrate in patients with primary hyperlipoproteinaemia.Curr Med Res Opin. 1981; 7: 489-502
- Reduced LDL- and increased HDL-apoproteins in patients with hypercholesterolaemia under treatment with bezafibrate.Atherosclerosis. 1981; 40: 153-158
- Clofibrate and related compounds in hyperlipoproteinaemia.in: A review. 5th ed. Postgrad Med J. 51. 1975: 66-71 (suppl 8)
- Treatment of hyperlipoproteinemia type II with etofibrate.Int J Clin Pharmacol Biopharm. 1979; 17: 498-502
- Effect of gemfibrozil on the blood levels of the high density lipoprotein subfractions HDL2 and HDL3.Res Clin Forums. 1982; 4: 77-83
- Effect of gemfibrozil on lipid and apoprotein parameters.Res Clin Forums. 1982; 4: 85-92
- The gemfibrozil study.Acta Med Scand. 1985; 701 ([Suppl]): 83-89
- The treatment of hyperlipoproteinaemia with gemfibrozil compared with placebo and clofibrate.N Z Med J. 1980; 92: 345-349
- Comparison of the effects of colestipol hydrochloride and clofibrate on plasma lipids and lipoproteins in the treatment of hypercholesterolemia.Atherosclerosis. 1981; 39: 35-43
- Dose-response study of the effect of ciprofibrate on serum lipoprotein concentrations in hyperlipoproteinaemia.Atherosclerosis. 1982; 42: 229-243
- Effects of bezafibrate on receptor-mediated and receptor-independent low density lipoprotein catabolism in type II hyperlipoproteinaemic subjects.Atherosclerosis. 1982; 44: 355-365
- Effects of fenofibrate on plasma lipids: double-blind, multicenter study in patients with type II A and type II B hyperlipidemia.Arteriosclerosis. 1986; 6: 670-678
- Effect of bezafibrate on the high-density lipoprotein subfractions HDL2 and HDL3 in primary hyperlipoproteinemia type IV.Artery. 1980; 7: 464-470
- Changes in the concentration and composition of lipids and lipoproteins in primary hyperlipoproteinemia during treatment with bezafibrate.Arzneimittel-Forschung. 1983; 33: 1185-1190
- Fenofibrate and colestipol; effects on serum and lipoprotein lipids and apolipoproteins in familial hypercholesterolaemia.Eur J Clin Pharmacol. 1986; 30: 191-194
- Changes in serum lipoprotein pattern following bezafibrate.in: Differential effects in type II and in type II B hyperlipoproteinemic patients. 5th ed. Pharmacol Res Commun. 17. 1985: 181-191
- Effect of colestipol and clofibrate on plasma lipid and lipoprotein in type II A hyperlipoproteinemia.Metabolism. 1981; 30: 605-609
- Effect of colestipol and clofibrate, singly and in combination, on plasma lipid and lipoproteins in type II B hyperlipoproteinemia.Metabolism. 1981; 30: 610-615
- Gemfibrozil therapy in primary hypertriglyceridemia associated with coronary heart disease.in: Effects on metabolism of low-density lipoproteins. 5th ed. JAMA. 253. 1985: 2398-2403
- Plasma and lipoprotein lipid responses to four hypolipid drugs.Lipids. 1984; 19: 73-79
- Investigations on the effect of timing on the efficacy of bezafibrate treatment of hypercholesterolemia.(abstr)in: Proceedings of the 9th International Symposium on Drugs Affecting Lipid Metabolism. 1986: 61
- Ciprofibrate multicentric study in 6,812 hyperlipidemic patients.(abstr)in: Proceedings of the 9th International Symposium on Drugs Affecting Lipid Metabolism. 1986: 62
- Effects of fenofibrate (200 mg once a day) on plasma lipids and apoproteins in type II B hyperlipoproteinaemic patients.(abstr)in: Proceedings of the 9th International Symposium on Drugs Affecting Lipid Metabolism. 1986: 64
- Effectiveness of bezafibrate in the treatment of primary hyperlipoproteinemia.(abstr)in: Proceedings of the 9th International Symposium on Drugs Affecting Lipid Metabolism. 1986: 98
- An overview of the effects of p-chlorphenoxyisobutyric acid derivatives on lipoprotein metabolism.in: Fears R Pharmacological control of hyperlipidemia. JR Prous Science Publishers, Barcelona, Spain1986: 135-144
- Effects of gemfibrozil on serum lipids.Am J Med. 1983; 74: 23-27
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© 1987 Published by Elsevier Inc.
