COMPARATIVE EFFECTS OF GEMFIBROZIL AND CLOFIBRATE IN TYPE-III HYPERLIPOPROTEINEMIA

Type III hyperlipoproteinemia (dysbetalipoproteinemia) is characterize d by elevated concentrations of plasma cholesterol and triglycerides d ue to an increase in very low density lipoprotein (VLDL) remnant lipop roteins. In a retrospective analysis we observed that in 12 patients w ith this disorder, gemfibrozil reduced concentrations of total cholest erol, VLDL cholesterol and triglycerides by 48%, 72% and 68%, respecti vely. These changes were greater than those reported in a similar numb er of patients treated with clofibrate. Comparative data on the effica cy of different fibrates in this disorder are very limited; to assess this further we have compared the hypolipidemic effects of gemfibrozil (600 mg twice daily) and clofibrate (1 g twice daily) in six patients with well-characterized type III hyperlipoproteinemia. Baseline value s were obtained after at least 8 weeks on diet and treatment values we re obtained after 6 and 8 weeks of treatment with each drug. Treatment with clofibrate and gemfibrozil both resulted insignificant reduction s in the plasma concentrations of total cholesterol (40% and 54%), VLD L cholesterol (59% and 79%) and total triglycerides (48% and 70%), as well as a significant increase in HDL cholesterol (9% and 7%). Gemfibr ozil was, however, significantly (P < 0.05) more effective in reducing plasma concentrations of total cholesterol, VLDL cholesterol and trig lycerides than was clofibrate, in the same patients.