Changes in the concentration and composition of lipids and lipoproteins in primary hyperlipoproteinemia during treatment with bezafibrate.

The effect of 2-(4-chlorobenzoyl-aminoethyl-phenoxy)-2-methylpropionic acid (bezafibrate, Cedur) at doses of 3 x 150 mg and 4 x 150 mg daily on lipids and lipoproteins in 27 patients (3 type IIa, 7 type IIb, 1 type III, 12 type IV and 4 type V) was investigated over a period of 24 weeks in a single-blind study. The lower dose was administered for the first 12 weeks and then the higher dose was given. Plasma triglycerides were reduced in all types. This was mainly caused by a massive reduction in VLDL triglycerides. Plasma cholesterol decreased in the types IIa, IIb, III as a result of the reduction of the LDL cholesterol. In type IV, the plasma cholesterol concentration remained unchanged because of a significant rise in the LDL cholesterol (+14%). The HDL cholesterol rose in all types, statistically significantly in the type IV. Phospholipids and protein behaved in an analogous fashion. In comparison with a control group, the lipoprotein fractions VLDL, LDL and HDL retained their abnormal composition in the types IIa, IIb and IV even when the lipid concentrations were massively lowered by bezafibrate. The drug treatment only led to a reduction of circulating lipoproteins in the blood, but didn't contribute to a normalisation of the lipoprotein composition. In the type V, a shift in the direction of type IV was observed. Bezafibrate proved to be well tolerated.