Efficacy and tolerability of coenzyme A vs pantethine for the treatment of patients with hyperlipidemia: A randomized, double-blind, multicenter study

J Clin Lipidol. Sep-Oct 2015;9(5):692-7. doi: 10.1016/j.jacl.2015.07.003. Epub 2015 Jul 11.

Abstract

Background: New, safer, and more effective agents to treat hyperlipidemia and thereby prevent cardiovascular events are under research.

Objective: To evaluate the lipid-lowering effects and safety of a natural hypolipidemic compound, coenzyme A (CoA) capsule, in Chinese patients with moderate dyslipidemia, compared with pantethine.

Methods: Overall, 216 subjects (124 males and 92 females; age, 18-75 years) with moderate dyslipidemia (triglyceride [TG], 2.3-6.5 mmol/L) were randomly divided into 2 groups administered CoA 400 U/d (n = 111) or pantethine 600 U/d (n = 105). Blood lipoproteins, liver and renal function, blood glucose, and complete blood count were measured at baseline and after 4- and 8-week treatment.

Results: TG reduction was 26.0% with CoA and 17.4% with pantethine after 4 weeks and 33.3% and 16.5% after 8 weeks; compared with baseline, the reduction was significant (P < .01) in both groups. The difference between the 2 groups was significant at both 4 weeks (P = .0413) and 8 weeks (P < .001). Compared with baseline, total cholesterol and non-high-density lipoprotein cholesterol (non-HDL-C) were reduced, whereas HDL-C was increased with CoA after 8 weeks (all P < .05). Compared with pantethine, total cholesterol (P = .026) and non-HDL-C (P = .005) were significantly reduced after 8 weeks of CoA treatment. There was no statistical difference in low-density lipoprotein cholesterol or HDL-C between the 2 groups (P > .05) and no difference in blood glucose, hepatic or renal function, myopathy, or gastrointestinal tract symptoms.

Conclusions: CoA can improve TG and other lipoprotein parameters to a greater extent than pantethine in moderate dyslipidemia, with no obvious adverse effects.

Keywords: Adverse effect; Coenzyme A; Dyslipidemia; Non–high-density lipoprotein cholesterol; Triglyceride.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Coenzyme A / adverse effects*
  • Coenzyme A / pharmacology*
  • Coenzyme A / therapeutic use
  • Double-Blind Method
  • Female
  • Humans
  • Hyperlipidemias / blood
  • Hyperlipidemias / drug therapy*
  • Lipoproteins / blood
  • Male
  • Middle Aged
  • Pantetheine / adverse effects
  • Pantetheine / analogs & derivatives*
  • Pantetheine / pharmacology
  • Pantetheine / therapeutic use
  • Safety*
  • Treatment Outcome
  • Triglycerides / blood
  • Young Adult

Substances

  • Lipoproteins
  • Triglycerides
  • Pantetheine
  • pantethine
  • Coenzyme A