Brown W V, Dujovne C A, Farquhar J W, Feldman E B, Grundy S M, Knopp R H, Lasser N L, Mellies M J, Palmer R H, Samuel P
Arteriosclerosis. 1986 Nov-Dec;6(6):670-8. doi: 10.1161/01.atv.6.6.670.
Of 240 patients with Type IIa and IIb hypercholesterolemia recruited in 11 centers, 227 were randomized to double-blind treatment with either fenofibrate (100 mg three times daily) or matching placebo for 24 weeks. A group of 192 of these patients were studied for a further 24 weeks during which all received fenofibrate in open label fashion. For the 92 Type IIa patients receiving fenofibrate in the double-blind phase, there were significant reductions (p less than 0.01 compared to baseline) in total plasma cholesterol (-18%), LDL-cholesterol (-20%), VLDL-cholesterol (-38%) and total triglycerides (-38%). Mean plasma HDL-cholesterol in these patients increased by 11% (p less than 0.01). With the exception of LDL, which was not high before treatment, similar changes were seen in the 24 fenofibrate-treated Type IIb subjects. Lipid parameters of placebo-treated patients did not change significantly. This pattern of change was repeated in the open period for the 94 patients previously on placebo, while the 98 who had been on fenofibrate remained stable with small further reductions in total and LDL cholesterol (-38% and -5.5% respectively). Adverse effects were some allergic-type skin reactions early in treatment and an occasional increase in transaminases, BUN, or creatinine. The results were similar to those obtained in European open trials of fenofibrate and were better than the lipid changes seen at comparable times in the Lipid Research Clinics Coronary Primary Prevention Trial (LRC-CPPT) cholestyramine study.
在11个中心招募的240例IIa型和IIb型高胆固醇血症患者中,227例被随机分为双盲治疗组,分别接受非诺贝特(每日3次,每次100mg)或匹配的安慰剂治疗24周。其中192例患者又接受了为期24周的开放标签研究,在此期间全部接受非诺贝特治疗。在双盲阶段接受非诺贝特治疗的92例IIa型患者中,血浆总胆固醇(-18%)、低密度脂蛋白胆固醇(-20%)、极低密度脂蛋白胆固醇(-38%)和总甘油三酯(-38%)均显著降低(与基线相比,p<0.01)。这些患者的平均血浆高密度脂蛋白胆固醇升高了11%(p<0.01)。除治疗前不高的低密度脂蛋白外,24例接受非诺贝特治疗的IIb型患者也出现了类似变化。安慰剂治疗患者的血脂参数无显著变化。此前接受安慰剂治疗的94例患者在开放期重复出现了这种变化模式,而此前接受非诺贝特治疗的98例患者血脂保持稳定,总胆固醇和低密度脂蛋白胆固醇进一步小幅降低(分别为-38%和-5.5%)。不良反应包括治疗早期出现的一些过敏型皮肤反应,以及偶尔出现的转氨酶、尿素氮或肌酐升高。结果与欧洲非诺贝特开放试验的结果相似,且优于脂质研究临床冠心病一级预防试验(LRC-CPPT)中消胆胺研究在相应时间观察到的血脂变化。