Hyperlipoproteinemia Clinical Trial
Official title:
Randomized Head-to-Head Comparison of Coenzyme A Capsule and Pantethine Capsule for Safety and Efficacy On Patients With Hyperlipidemia: A Phase III, Multicenter, Double-blinded, Double Dummy Clinical Trial.
The purpose of this study is to compare the lipid lowering effects and clinical safety of a natural hypolipidemic compound, coenzyme A capsule with a marketed drug, Pantethine 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 compares the
safety and effectiveness of oral CoA and Pantetheine.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Primary Purpose: Treatment
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