Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients

Castaño, Gladys; Más, Rosa; Arruzabala, M.L. de; Noa, Miríam; Illnait, José; Fernández, Julio César; Molina, Vivián; Menéndez, Addis Bellma

doi:10.1016/s0021-9150(00)81432-x

Cited by 21 publications

(48 citation statements)

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“…The effects of policosanol on LDL-C and TC levels in this study are consistent with those reported for this dose and treatment duration in populations with broad ranges of TC indicating mild to severe hypercholesterolemia. 22,23,25,27 Because 84% of policosanol-treated patients achieved reductions Ն15% in serum LDL-C level and 90% achieved LDL-C goals as defined by expert guidelines, 9-11 the primary efficacy goal of these changes being achieved in Ն70% of patients was met. The frequency of study patients achieving goal reductions of LDL-C was high and was comparable to that reported for highly effective statins.…”

Section: Discussionmentioning

confidence: 99%

“…22 This change is an additional benefit of policosanol treatment that may contribute to reducing the risk for CHD after long-term therapy. Likewise, although the effects of policosanol on TG have not been consistent in all studies, modest but significant reductions have been obtained in some, 20,21,27 and those findings are consistent with the present results.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 This drug has proven cholesterol-lowering efficacy in type II hypercholesterolemia [18][19][20][21][22][23][24][25] and dyslipidemia secondary to type 2 diabetes mellitus. 26,27 Policosanol inhibits cholesterol biosynthesis between acetate consumption and mevalonate production 28,29 through the indirect regulation of HMG-CoA reductase activity.…”

Section: Program (Ncep)mentioning

confidence: 99%

“…30 Policosanol increases LDL receptor-dependent processing, 28 enhancing the catabolic rate of LDL. 29 Clinical trials [18][19][20][21][22][23][24][25][26][27] and postmarketing studies 31,32 have shown that policosanol is well tolerated. The therapeutic range of policosanol is 5 to 20 mg/d.…”

Section: Program (Ncep)mentioning

confidence: 99%

“…[18][19][20][21][22][23][24][25][26][27] Most of the patients included in these studies had moderate hypercholesterolemia (TC Ն6.1 and Ͻ7.8 mmol/L), whereas patients with mild hypercholesterolemia have not been included in some studies due to the limits of inclusion criteria (TC Ն6.1 mmol/L).…”

Section: Program (Ncep)mentioning

confidence: 99%

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Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study

Castaño

Más

Fernández

et al. 2003

Current Therapeutic Research

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Background: Hypercholesterolemia is a major risk factor for coronary heart disease. Clinical studies have shown that lowering elevated serum cholesterol levels, particularly low-density lipoprotein cholesterol (LDL-C), is beneficial for patients with borderline to mildly elevated serum total cholesterol (TC) levels (5.0-6.0 mmol/L). Policosanol is a cholesterol-lowering drug made from purified sugar cane wax. The therapeutic range of policosanol is 5 to 20 mg/d.Objective: This study investigated the efficacy and tolerability of policosanol 5 mg/d in patients with borderline to mildly elevated serum TC levels.Methods: This 14-week, single-center, prospective, double-blind, placebocontrolled, parallel-group, comparative study was conducted in men and women aged 25 to 75 years with a serum TC level Ն4.8 to Ͻ6.0 mmol/L. After a 6-week run-in period in which patients were placed on therapeutic lifestyle changes, in particular a cholesterol-lowering diet, patients were randomly assigned to receive policosanol 5-mg tablets or placebo tablets once daily with the evening meal for 8 weeks, and the diet was continued throughout the study. Lipid profile variables, safety indicators, adverse events (AEs), and compliance with study medications were assessed.Results: One hundred patients (71 women, 29 men; mean [SD] age, 52 [10] years) entered the study after the dietary run-in period. After 8 weeks of treatment, the mean (SD) serum LDL-C level decreased significantly in the policosanol group (P Ͻ 0.001 vs baseline and placebo) from 3.57 (0.30) mmol/L to 2.86 (0.41) mmol/L (change, Ϫ19.9%). Significantly more patients in the policosanol group The percentage changes were significantly different between the policosanol and placebo groups for serum LDL-C, TC, and HDL-C levels (P Ͻ 0.001, P Ͻ 0.001, and P Ͻ 0.05, respectively), but not for TG. In the placebo group, changes in lipid profile variables from baseline were not significant. Policosanol did not significantly impair any safety indicator and was well tolerated. Three patients (3%) (1 patient [2%] in the policosanol group; 2 patients [4%] in the placebo group) withdrew from the trial, none because of AEs. Two patients (1 patient [2%] each in the policosanol and placebo groups) withdrew from the study because of an unwillingness to return for follow-up; 1 patient (2%) in the placebo group had a change of address and could not be followed up. Overall, 4 patients (4%) (1 patient [2%] in the policosanol group; 3 [6%], placebo) reported AEs; all were mild. Of the patients who received placebo and reported AEs, all 3 (6%) experienced heartburn, and 1 (2%) also experienced dry skin, while the policosanol-treated patient (2%) who reported an AE experienced headache. Conclusions:In this study of patients with borderline to mildly elevated serum TC levels, based on the criterion that Ն70% of policosanol-treated patients reached the LDL-C goal of a decrease Ն15% from baseline whenever this proportion was different with respect to placebo, 8 weeks of treatment with policosanol ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Program (Ncep)mentioning

confidence: 99%

Section: Program (Ncep)mentioning

confidence: 99%

Section: Program (Ncep)mentioning

confidence: 99%

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Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study

Castaño

Más

Fernández

et al. 2003

Current Therapeutic Research

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Statin therapy depresses total body fat oxidation in the absence of genetic limitations to fat oxidation

Fisher¹,

Meksawan

Limprasertkul

et al. 2007

J of Inher Metab Disea

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Cholesterol lowering drugs are associated with myopathic side effects in 7% of those on therapy, which is reversible in most, but not all patients. This study tested the hypothesis that total body fat oxidation (TBFO) is reduced by statins in patients with genetic deficiencies in FO, determined by white blood cells (FOwbc) and by molecular analysis of common deficiencies, and would cause intolerance in some patients. Six patients on statin therapy without myopathic side effects (tolerant) and 7 patients who had previously developed statin-induced myopathic symptoms (intolerant) (age = 58 +/- 8.25 yrs, ht. = 169 +/- 11 cm, and wt. = 75.4 +/- 14.2 kg) were tested for TBFO (Respiratory Exchange Ratio, RER) pre- and during exercise. FOwbc was not significantly different between tolerant and intolerant (0.261 +/- 0.078 vs. 0.296 +/- 0.042 nmol/h per 10(9) wbc), or normals (0.27 +/- 0.09 nmol/h per 10(9) wbc) and no common molecular abnormalities were found. Pre-exercise RER (0.73 +/- 0.05 vs. 0.84 +/- 0.05) was significantly lower in the intolerant group and the VO2 at RER = 1.0 (1.27 +/- 0.32 vs. 1.87 +/- 0.60 L/min) greater than the tolerant. Post-exercise lactates were not different between groups. Although dietary fat intake was not different, blood lipoprotein levels, particularly triglycerides were 35% lower in tolerant than previously intolerant. TBFO and blood lipoproteins were reduced in tolerant patients in spite of the absence of genetic limitations, but not in the intolerant group as hypothesized. Although not conclusive, these data suggest the need for a prospective study of the effects of statins on fat oxidation.

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Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study

Francini-Pesenti

Brocadello

Beltramolli

et al. 2008

Complementary Therapies in Medicine

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Effects of policosanol and pravastatin on lipid profile, platelet aggregation and endothelemia in older hypercholesterolemic patients

Cited by 21 publications

References 0 publications

Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study

Effects of policosanol on borderline to mildly elevated serum total cholesterol levels: a prospective, double-blind, placebo-controlled, parallel-group, comparative study

Statin therapy depresses total body fat oxidation in the absence of genetic limitations to fat oxidation

Sugar cane policosanol failed to lower plasma cholesterol in primitive, diet-resistant hypercholesterolaemia: A double blind, controlled study

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