Hyperlipoproteinemia Clinical Trial
Official title:
The Effects of Coenzyme A on Serum Lipids in Patients With Hyperlipidemia: a Randomized, Double-blinded, Placebo-controlled, Multi-center Clinical Trial
The purpose of this study is to evaluate the lipid lowering effects and clinical safety of a natural hypolipidemic compound, coenzyme A (CoA) capsule in Chinese patients with moderate dyslipidemia.
Hyperlipidemia plays important roles in the development and progression of atherosclerosis.
Modulating lipid levels has been shown to reduce the development of atherosclerosis and
incidence of cardiovascular disease. The HMG-CoA reductase inhibitors (also known as statins)
are the most effective agents available in the management of hyperlipidemia and prevention of
major cardiovascular events. Although statin based therapy is commonplace in primary and
secondary prevention, several economical, clinical and safety issues have been raised, so
that there is ongoing research into new, safer and more effective agents to be used alone or
in combination with existing cardiovascular drugs.
Coenzyme A (CoA) is a ubiquitous essential cofactor that plays a central role in the
metabolism of carboxylic acids, including short- and long-chain fatty acids, as well as
carbohydrate and protein. In the metabolic pathway of lipid, CoA participates in fatty acid
β-oxidation, promoting triglyceride (TG) catabolism. Previous research revealed that
insufficiency of CoA in vivo influenced fatty acid β-oxidation catabolism and impaired
clearance of TG from plasma, which was supposed to be one plausible reason resulting in type
Ⅱb and Ⅳ hyperlipoproteinemia. In addition, epidemiological studies showed the prevalence of
serum lipids level increased with age, which may be related to the reduction of CoA synthesis
in aging individuals. Moreover, studies on animals have given evidence to prove that
supplement of CoA had normalizing activity on plasma lipids in dyslipidemia.
Pantethine is a versatile and very well tolerated hypolipidemic agent that can decrease serum
triglycerides, LDL cholesterol, and apolipoprotein B, while increasing HDL cholesterol and
apolipoprotein A-I. Pantethine is the disulfide of pantetheine which per se occurs naturally
as a product of coenzyme A catabolism. Theoretically, antihyperlipidemia effect of CoA should
be more directly and effectively than pantethine. Researches on rabbits and rats models prove
that high dose CoA orally can relieve fasting hyperlipidemia and insulin resistance induced
by high fat diet. So far there has not been sufficient clinical research data to support the
efficacy of CoA in dyslipidemia patients. The present study shows, for the first time, the
safety, effectiveness of oral CoA.
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