Efficacy and tolerability of coenzyme A vs pantethine for the treatment of patients with hyperlipidemia: A randomized, double-blind, multicenter study.
BACKGROUND
New, safer, and more effective agents to treat hyperlipidemia and thereby prevent cardiovascular events are under research.


OBJECTIVE
To evaluate the lipid-lowering effects and safety of a natural hypolipidemic compound, coenzyme A (CoA) capsule, in Chinese patients with moderate dyslipidemia, compared with pantethine.


METHODS
Overall, 216 subjects (124 males and 92 females; age, 18-75 years) with moderate dyslipidemia (triglyceride [TG], 2.3-6.5 mmol/L) were randomly divided into 2 groups administered CoA 400 U/d (n = 111) or pantethine 600 U/d (n = 105). Blood lipoproteins, liver and renal function, blood glucose, and complete blood count were measured at baseline and after 4- and 8-week treatment.


RESULTS
TG reduction was 26.0% with CoA and 17.4% with pantethine after 4 weeks and 33.3% and 16.5% after 8 weeks; compared with baseline, the reduction was significant (P < .01) in both groups. The difference between the 2 groups was significant at both 4 weeks (P = .0413) and 8 weeks (P < .001). Compared with baseline, total cholesterol and non-high-density lipoprotein cholesterol (non-HDL-C) were reduced, whereas HDL-C was increased with CoA after 8 weeks (all P < .05). Compared with pantethine, total cholesterol (P = .026) and non-HDL-C (P = .005) were significantly reduced after 8 weeks of CoA treatment. There was no statistical difference in low-density lipoprotein cholesterol or HDL-C between the 2 groups (P > .05) and no difference in blood glucose, hepatic or renal function, myopathy, or gastrointestinal tract symptoms.


CONCLUSIONS
CoA can improve TG and other lipoprotein parameters to a greater extent than pantethine in moderate dyslipidemia, with no obvious adverse effects.
Department of Cardiology, The Second Xiangya Hospital of Central South University, Central South University, Changsha, Hunan, P.R China.
Ya-qin
YQ
Chen
Department of Cardiology, The Second Xiangya Hospital of Central South University, Central South University, Changsha, Hunan, P.R China. Electronic address: zhaosp@medmail.com.cn.
Shui-ping
SP
Zhao
Department of Cardiology, The Second Xiangya Hospital of Central South University, Central South University, Changsha, Hunan, P.R China.
Yu-hong
YH
Zhao
D000293:Adolescent; D000328:Adult; D000368:Aged; D003065:Coenzyme A / Q000009:adverse effects* / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy*; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D010204:Pantetheine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D012449:Safety; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D055815:Young Adult
D008074:Lipoproteins; D014280:Triglycerides; D010204:Pantetheine; C005425:pantethine; D003065:Coenzyme A
Adverse effect; Coenzyme A; Dyslipidemia; Non–high-density lipoprotein cholesterol; Triglyceride