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.
Departamento de Endocrinología y Metabolismo, Instituto Nacional de la Nutrición, México City, Mexico. caguilarsalinas@yahoo.com
Carlos A
CA
Aguilar-Salinas
Andréia
A
Assis-Luores-Vale
Benjamín
B
Stockins
Hector Mario
HM
Rengifo
José
J
Dondici Filho
Abrahão
A
Afiune Neto
Lísia Marcílio
LM
Rabelo
Kerginaldo Paulo
KP
Torres
José Egídio Paulo de
JE
Oliveira
Carlos Alberto
CA
Machado
Eliana
E
Reyes
Victor
V
Saavedra
Fernando
F
Florenzano
Ma Victoria
MV
Hernández
Sergio
S
Hernandez Jiménez
Erika
E
Ramírez
Cuauhtémoc
C
Vazquez
Saul
S
Salinas
Ismael
I
Hernández
Octavio
O
Medel
Ricardo
R
Moreno
Paula
P
Lugo
Ricardo
R
Alvarado
Roopa
R
Mehta
Victor
V
Gutierrez
Francisco J
FJ
Gómez Pérez