Bezafibrate: effects on serum lipoproteins and haemostatic factors

After a period of dietary stabilization 68 patients with primary hyperlipoproteinemia have been treated with bezafibrate 200 mg t.i.d.. Cholesterol (C) and triglycerides (TG) were measured in lipoprotein fractions before and after 1 month of therapy. In type IIa patients, the main change was a 23% decrease of LDL-C. LDL-TG and VLDL lipids also underwent a reduction. In type IIb patients both VLDL and LDL lipids significantly decreased. In type IV patients VLDL lipids decreased and LDL-C rose. HDL-C significantly increased in all groups of patients owing to an increase of HDL3-C, while the C content of HDL2 subfraction significantly increased only in hypertriglyceridemic patients (type IIb and IV). The change in VLDL and LDL lipids resulted to be positively correlated with their pretreatment value. Apoprotein B decreased by 24% in type IIa and by 29% in type IIb patients. Apoprotein A-I increased by 19% in type IIb patients and underwent a small and non significant increase in type IIa patients. The change in serum lipoprotein lipid concentration was associated with a change in lipoprotein lipid composition. C:TG ratio decreased in LDL of type IIa, increased in LDL of type IV and in HDL of all groups of patients. Plasma fibrinogen resulted to be 10% lower after 1 month of bezafibrate than before. The diminution was greater in patients with plasma fibrinogen higher than average and was not related with the changes in serum lipoprotein lipid concentration.