Vahlquist C, Olsson A G, Lindholm A, Vahlquist A
Department of Dermatology, University Hospital of Linköping, Sweden.
Acta Derm Venereol. 1995 Sep;75(5):377-80. doi: 10.2340/0001555575377380.
Hyperlipidemia is a common side-effect of oral retinoid treatment, which sometimes interferes with long-term therapy. To evaluate the safety and efficacy of the lipid-lowering drug gemfibrozil on retinoid-associated hyperlipidemia, we studied the clinical response and the plasma lipoprotein levels in 22 acitretin-treated (0.25-0.75 mg/kg) patients mainly suffering from psoriasis. Gemfibrozil or placebo was given in a double-blind cross-over fashion to 14 patients, who after 8 weeks of acitretin therapy and dietary advice exhibited hyperlipidemia (triglyceride levels > or = 50% above baseline and/or > or = 2.0 mmol/l). Serum triglycerides remained high (3.7 +/- 2.4 mmol/l) during placebo treatment but were reduced after 8 weeks of gemfibrozil treatment (p < 0.01). The total cholesterol level decreased slightly (p < 0.05) during gemfibrozil treatment, but the LDL/HDL ratio did not change significantly. No untoward effects of gemfibrozil on acitretin dose-response and clinical side-effects were noted. Gemfibrozil thus appears useful in patients prone to retinoid-induced hyperlipidemia unresponsive to dietary treatment and acitretin dose reductions.
高脂血症是口服维甲酸治疗的常见副作用，有时会干扰长期治疗。为了评估降脂药物吉非贝齐对维甲酸相关高脂血症的安全性和有效性，我们研究了22例主要患有银屑病的阿维A治疗（0.25 - 0.75毫克/千克）患者的临床反应和血浆脂蛋白水平。吉非贝齐或安慰剂以双盲交叉方式给予14例患者，这些患者在接受8周阿维A治疗和饮食建议后出现高脂血症（甘油三酯水平比基线高出≥50%和/或≥2.0毫摩尔/升）。在安慰剂治疗期间血清甘油三酯仍保持高水平（3.7±2.4毫摩尔/升），但在接受8周吉非贝齐治疗后降低（p<0.01）。在吉非贝齐治疗期间总胆固醇水平略有下降（p<0.05），但低密度脂蛋白/高密度脂蛋白比值没有显著变化。未观察到吉非贝齐对阿维A剂量反应和临床副作用有不良影响。因此，吉非贝齐似乎对易患维甲酸诱导的高脂血症且对饮食治疗和降低阿维A剂量无反应的患者有用。
