Comparison of clofibrate and bezafibrate in type IIa and type IIb hyperlipoproteinemia

: In a randomized block-trial the comparative efficacy and side-effects of clofibrate (2 X 1 g), placebo and bezafibrate (3 X 150 mg) were tested in groups of 24 patients each with hyperlipoproteinemia type IIa and IIb. Each period of treatment was 2 months. Both bezafibrate and clofibrate as compared to placebo were associated with a significant lowering of triglycerides and cholesterol: triglycerides by 30% in type IIa and a 41% reduction in type IIb, whereas clofibrate lowered triglycerides by 23% in type IIa and 28% in type IIb. Bezafibrate reduced total cholesterol by 18% in type IIa and 12% in type IIb as opposed to clofibrate reducing cholesterol by 16% in type IIa and 8% in type IIb. Bezafibrate compared to clofibrate was shown to be significantly more effective in lowering triglycerides in type IIa correlating to a significant reduction of VLDL- and LDL-triglycerides in this type. Both substances significantly lowered LDL-cholesterol in type IIa; in type IIb only bezafibrate was effective. HDL-cholesterol increased significantly with bezafibrate. The effect of clofibrate raising LDL-cholesterol in dependence on the initial concentration of the VLDL-triglycerides was seen less frequently after bezafibrate and only with higher initial VLDL-concentrations as compared to clofibrate. Patients tolerated both bezafibrate and clofibrate equally well. It should be considered that bezafibrate was not given in the optimal dose of 3 X 200 mg.