Klinische Prufung von "Tibric Acid", einem neuen lipidsenkenden Stoff

Tibric acid, a new hypolipidemic agent, was given to 31 patients with different types of hyperlipoproteinemia and to 1 healthy individual in a daily dose of 500-1500 mg. In 6 patients with type IV hyperlipoproteinemia of moderate degree and without chylomicronemia, a statistically significant reduction in serum triglyceride values was obtained by giving the drug in a single daily dose for 24 wk. In a first group of 6 patients with severe type IV hyperlipoproteinemia and chylomicronemia the same therapeutic schedule failed to produce a positive result. In a second group of 5 patients with severe type IV hyperlipoproteinemia and presence of chylomicrons, the serum triglyceride and cholesterol values were significantly lowered by application of the same amount of this drug divided into 3-4 daily doses for a period of 16 wk. In 4 cases of type IIA hyperlipoproteinemia of moderate degree, a significant reduction (20-25%) in serum cholesterol values was obtained by giving the drug divided into 3-4 daily doses for a period of 16 wk. In 5 cases of type IIB hyperlipoproteinemia the serum cholesterol and triglyceride values were significantly reduced by means of a single daily dose of the drug. In the normal individual no changes in serum lipid values were observed during the treatment. Tibric acid was generally well tolerated. Occasional side effects were insomnia (6 cases) and slight cephalaea (3 cases), but in all these cases the therapy could be continued. In 4 other cases the treatment had to be discontinued because of pruritus (1 patient with chronic cholecystopathy), diarrhea (1 case), nausea (1 case) and fresh myocardial infarction (1 case). In none of these patients could the pathological signs be attributed to the medication with tibric acid. During this investigation some very positive clinical responses were observed: improvement in peripheral circulation in 5 of 9 patients with peripheral obstructive arteriopathy, disappearance of eruptive xanthomas in 1 case, and improvement of diabetes in 1 patient treated with insulin. Another interesting observation was the antagonistic effect of propranolol in 1 case. On the basis of the observations it is concluded that tibric acid is useful in the treatment of hypertriglyceridemias and hypercholesterolemias of moderate degree. Further clinical investigations are needed to determine whether tibric acid has real advantages with respect to clofibrate. (18 references).