Ciprofibrate therapy in patients with hypertriglyceridemia and low high density lipoprotein (HDL)-cholesterol: greater reduction of non-HDL cholesterol in subjects with excess body weight (The CIPROAMLAT study).
BACKGROUND
Hypertriglyceridemia in combination with low HDL cholesterol levels is a risk factor for cardiovascular disease. Our objective was to evaluate the efficacy of ciprofibrate for the treatment of this form of dyslipidemia and to identify factors associated with better treatment response.


METHODS
Multicenter, international, open-label study. Four hundred and thirty seven patients were included. The plasma lipid levels at inclusion were fasting triglyceride concentrations between 1.6-3.9 mM/l and HDL cholesterol < or = 1.05 mM/l for women and < or = 0.9 mM/l for men. The LDL cholesterol was below 4.2 mM/l. All patients received ciprofibrate 100 mg/d. Efficacy and safety parameters were assessed at baseline and at the end of the treatment. The primary efficacy parameter of the study was percentage change in triglycerides from baseline.


RESULTS
After 4 months, plasma triglyceride concentrations were decreased by 44% (p < 0.001). HDL cholesterol concentrations were increased by 10% (p < 0.001). Non-HDL cholesterol was decreased by 19%. A greater HDL cholesterol response was observed in lean patients (body mass index < 25 kg/m2) compared to the rest of the population (8.2 vs 19.7%, p < 0.001). In contrast, cases with excess body weight had a larger decrease in non-HDL cholesterol levels (-20.8 vs -10.8%, p < 0.001). There were no significant complications resulting from treatment with ciprofibrate.


CONCLUSIONS
Ciprofibrate is efficacious for the correction of hypertriglyceridemia / low HDL cholesterol. A greater decrease in non-HDL cholesterol was found among cases with excess body weight. The mechanism of action of ciprofibrate may be influenced by the pathophysiology of the disorder being treated.
Aguilar-Salinas
Carlos A
CA
Departamento de Endocrinología y Metabolismo, Instituto Nacional de la Nutrición, México City, Mexico. caguilarsalinas@yahoo.com
Assis-Luores-Vale
Andréia
A
Stockins
Benjamín
B
Rengifo
Hector Mario
HM
Dondici Filho
José
J
Afiune Neto
Abrahão
A
Rabelo
Lísia Marcílio
LM
Torres
Kerginaldo Paulo
KP
Oliveira
José Egídio Paulo de
JE
Machado
Carlos Alberto
CA
Reyes
Eliana
E
Saavedra
Victor
V
Florenzano
Fernando
F
Hernández
Ma Victoria
MV
Hernandez Jiménez
Sergio
S
Ramírez
Erika
E
Vazquez
Cuauhtémoc
C
Salinas
Saul
S
Hernández
Ismael
I
Medel
Octavio
O
Moreno
Ricardo
R
Lugo
Paula
P
Alvarado
Ricardo
R
Mehta
Roopa
R
Gutierrez
Victor
V
Gómez Pérez
Francisco J
FJ