X-Message-Number: 14358
Date: Wed, 23 Aug 2000 15:24:39 -0700 (PDT)
From: Doug Skrecky <>
Subject: policosanol may the best lipid lowering supplement (long)

Citations: 1-5
  [Comparative effects of policosanol and two HMG-CoA
  reductase inhibitors on type II hypercholesterolemia]. [Spanish]
  Revista Medica de Chile.  127(3):286-94, 1999 Mar.
  BACKGROUND: Policosanol is a new cholesterol lowering agent
  derived from sugar cane. AIM: To compare the cholesterol lowering efficacy of
  policosanol with HMG CoA inhibitors. PATIENTS AND METHODS:
  Patients with a LDL cholesterol over 160 mg/dl were studied. If, after 6
  weeks of diet, cholesterol persisted elevated, they were doubly blind
  randomized to receive policosanol 10 mg/day (55 patients),
  lovastatin 20 mg/day (26 patients) or simvastatin 10 mg/day (25 patients).
  Serum cholesterol was measured again after 8 weeks of therapy. RESULTS:
  Initial demographic and laboratory data were similar among treatment groups.
  A 24% LDL cholesterol reduction was obtained with
  policosanol, compared with a 22% reduction with lovastatin
  and a 15% reduction with simvastatin. HDL cholesterol significantly increased
  in patients on policosanol and did not change in the other
  treatment groups. Adverse effects of policosanol were mild
  and unspecific. No changes in hepatic enzymes were observed. CONCLUSIONS:
  Policosanol is a safe and effective cholesterol reducing

  Effects of policosanol in patients with type II
  hypercholesterolemia and additional coronary risk factors.
  Clinical Pharmacology & Therapeutics.  65(4):439-47, 1999 Apr.
  INTRODUCTION: This study was undertaken to evaluate the efficacy, safety, and
  tolerability of policosanol, a new cholesterol-lowering
  drug, in patients with type II hypercholesterolemia and additional coronary
  risk factors. PATIENTS AND METHODS: After 5 weeks of a standard step-1
  lipid-lowering diet, 437 patients were randomized to receive, under
  double-blind conditions, 5 mg policosanol or placebo once a
  day with the evening meal for 12 weeks and 10 mg policosanol
  or placebo for the next 12 weeks. RESULTS: Both groups were similar at
  randomization. Policosanol (5 and 10 mg/day) significantly
  reduced (P < .001) serum low-density lipoprotein cholesterol (18.2% and
  25.6%, respectively) and cholesterol (13.0% and 17.4%), and it significantly
  raised (P < .01) high-density lipoprotein cholesterol (15.5% and 28.4%).
  Triglycerides remained unchanged after the first 12 weeks and lowered
  significantly (5.2%; P < .01) at study completion.
  Policosanol was safe and well tolerated, and no drug-related
  disturbances were observed. Two male patients who received placebo died
  during the study--one because of a myocardial infarction and the other
  because of a cardiac arrest that occurred during a surgical intervention.
  There were 11 serious adverse events (5.1%) in 10 patients who received
  placebo (4.6%), 7 of which were vascular, compared with no serious adverse
  events reported in patients receiving policosanol (P < .01).
  CONCLUSIONS: Subjects in the group treated with policosanol
  did not have serious adverse events during the 24-week study. This study
  shows that policosanol is effective, safe, and well
  tolerated in patients with hypercholesterolemia and concomitant coronary risk

  A double-blind, placebo-controlled study of the effects of
  policosanol in patients with intermittent claudication.
  Angiology.  50(2):123-30, 1999 Feb.
  This study was undertaken to evaluate the efficacy and tolerability of
  policosanol, a new cholesterol-lowering drug with
  concomitant antiplatelet effects, in patients with intermittent claudication.
  After a baseline period of 6 weeks, 62 patients were randomized to receive,
  under double-blind conditions, either placebo (31 patients) or
  policosanol (31), 10 mg twice daily. Walking distances in a
  treadmill (constant speed 3.2 km/hr, slope 10 degrees) were assessed before
  and after 6 months of treatment. Both groups were similar at randomization.
  Policosanol increased significantly (p < 0.01) the initial
  claudication distance from 132.5+/-13.5 m (baseline) to 205.7+/-36.3 m (after
  therapy) and the absolute claudication distance (p<0.0001) from 229.5+/-22.0
  m to 365.4+/-46.9 m; meanwhile both variables remained unchanged in the
  placebo group (p<0.05). The reduction of lower limb symptoms showed a greater
  benefit in the policosanol group. There was no significant
  change in either group in the ankle/arm pressure ratio. The treatment was
  well tolerated. There were 10 discontinuations (seven placebo, three
  policosanol) from the study. Six withdrawals occurred
  because of adverse events (AE); all were in placebo patients. There were five
  serious vascular AEs in the placebo group but none in the
  policosanol group (p<0.05). Overall, 12/31 (38.7%) placebo
  patients and 3/31 (9.7%) policosanol patients experienced
  AEs after randomization, which showed a lesser incidence of AEs in the
  policosanol group (p<0.01). The present study demonstrates a
  beneficial effect of policosanol in patients with
  intermittent claudication.

  Effect of policosanol on intimal thickening in rabbit cuffed
  carotid artery.
  International Journal of Cardiology.  67(2):125-32, 1998 Dec 1.
  We studied the effect of policosanol on smooth muscle cell
  proliferation in the cuffed carotid artery of the rabbit.
  Policosanol is a mixture of higher aliphatic primary
  alcohols isolated from sugar cane wax, with cholesterol lowering effects
  proved in experimental models and patients with type II hypercholesterolemia.
  It acts by inhibiting cholesterol biosynthesis. The positioning of a
  nonocclusive silicone collar around the rabbit carotid artery results in the
  formation of a neointima. We wished to determine whether
  policosanol orally administered prevented intimal
  thickening. Collars were placed around the left carotid for 15 days. The
  contralateral artery was sham operated. We included three experimental
  groups: a control received vehicle and two others
  policosanol at 5 and 25 mg Kg until sacrificed. Samples of
  arteries were examined by light and electron microscopy. To evaluate intimal
  thickening the cross-sectional area of intima and media were measured.
  Neointima was significantly reduced in policosanol-treated
  animals compared with controls. The smooth muscle cell proliferation was
  studied by the immunohistochemical detection of proliferating cell nuclear
  antigen and a significant reduction was observed in
  policosanol treated rabbits. It is concluded that
  policosanol has a protective effect on the neointima
  formation in this experimental model.

  Long-term therapy with policosanol improves treadmill
  exercise-ECG testing performance of coronary heart disease patients.
  International Journal of Clinical Pharmacology & Therapeutics.  36(9):469-73,
  1998 Sep.
  This study examined the effects of long-term lipid-lowering therapy with
  policosanol on the clinical evolution, and exercise-ECG
  testing responses of 45 coronary heart disease (CHD) patients with myocardial
  ischemia, documented by exercise 201T1-myocardial perfusion scintigraphy, in
  an overall randomized, double-blind, placebo-controlled trial, made for
  different test endpoints. Fifteen patients were treated with 5 mg of
  policosanol twice daily; another 15 patients were
  administered the same drug dose plus 125 mg aspirin; and the other 15
  patients received placebo plus equal aspirin dose. They were followed for 20
  months, previous baseline observations, with treadmill exercise-ECG, besides
  serum lipid test. Beneficial changes on proportions among the 2
  policosanol groups and the placebo group, showed an
  increment on functional capacity class, a decrement on rest and exercise
  angina, and a significant decrease in cardiac events, and in ischemic ST
  segment response, especially in the policosanol plus aspirin
  group (p = 0.05, X2(2df) = 5.8; p = 0.04, p = 0.02; Fisher). After treatment,
  sets of mean changes revealed an increase on maximum oxygen uptake, and a
  decline on double product simultaneously in both policosanol
  groups (p < or = 0.02, p < or = 0.002; Pillais, Hotellings' T2), while the
  placebo group was impaired. Aerobic functional capacity percent showed an
  increment in policosanol groups (p < or = 0.05, paired T).
  Lipid levels improved as other endpoints already reported. A supposed
  ergogenic effect of octacosanol, policosanol's main active
  compound, was not detected with this design. These results show that
  policosanol-treated CHD patients improved clinical
  evolution, and exercise-ECG responses, owing to the amelioration of
  myocardial ischemia, even more when administered with aspirin.

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