Effect of bezafibrate on lipids, lipoproteins, apolipoproteins and platelet aggregation in hypertriglyceridemic patients.

Twenty-seven hypertriglyceridemic patients were recruited for an open placebo-controlled, 7-month study of the effect of bezafibrate (CAS 41859-67-0, Bezalip, Cedur) on lipids, lipoproteins, apolipoproteins, and platelet aggregation. Patients received 3 placebo tablets a day for a stabilization period of 2 months, followed by a treatment period of 5 months during which one group received bezafibrate 200 mg 3 times a day, and a control group continued to receive placebo. Values measured at the end of the stabilization period were considered as the baseline values. Bezafibrate therapy significantly reduced triglycerides by 43%, and increased HDL-cholesterol by 22%. Apolipoprotein A-1 increased by 14%, and apolipoprotein A-2 by 42%. There was a small reduction of cholesterol (6%), and of apolipoprotein B (11%). A small increase occurred in LDL-cholesterol (2%), suggesting increased catabolism of high VLDL levels which were converted to LDL-cholesterol. Platelet aggregation was measured by the degree of light transmission through a platelet suspension. The improvement of the lipoprotein profile was associated with significant reduction of platelet aggregation in vitro, stimulated by adenosine diphosphate (ADP) at concentrations of 1.15 mumol/ml and 0.75 mumol/ml, and by collagen 2.0 micrograms/ml. Average decrease of platelet reactivity was 45%, 30% and 42%, respectively. The decrease of light transmission with ADP concentration of 2.3 mumol/ml was not significant, suggesting that the aggregatonic effect of the higher ADP concentration overcame the attenuating effect of bezafibrate. The control groups, displayed no significant changes in the blood constituents and platelet functions.(ABSTRACT TRUNCATED AT 250 WORDS)