A comparative study of the effects of acipimox and clofibrate in type III and type IV hyperlipoproteinemia

Atherosclerosis. 1985 Apr;55(1):51-62. doi: 10.1016/0021-9150(85)90165-0.


Acipimox, an analogue of nicotinic acid, is a hypolipidemic drug with antilipolytic activity. Ten patients with type III and 10 with type IV hyperlipoproteinemia participated in a comparative open cross-over study of the effect of acipimox (750 mg/day) and clofibrate (2 g/day) on lipoproteins, apoliproproteins and postheparin lipase activities during 6 weeks. During acipimox treatment 2 type III patients complained of flushing, resulting in one drop-out. In the type III patients serum cholesterol decreased 30% (P less than 0.01) during treatment with acipimox and 24% (P less than 0.01) with clofibrate, and serum triglycerides 48% (P less than 0.01) and 34% (P less than 0.01), respectively. In the type IV patients serum cholesterol remained unchanged and serum triglycerides decreased 34% (P less than 0.05) and 35% (P less than 0.01), respectively. HDL cholesterol increased during treatment with both drugs in both groups between 6 and 15% (P less than 0.05) mainly due to a rise in HDL3 cholesterol (d greater than 1.100 g/ml). LDL cholesterol increased significantly during treatment with clofibrate, but not with acipimox. There were no or slight changes in the apoproteins A and B. Postheparin lipoprotein lipase increased during clofibrate treatment and hepatic lipase decreased during acipimox treatment. We concluded that acipimox in a dose of 750 mg/day has a similar hypolipidemic effect as 2 g clofibrate daily in type III and IV hyperlipoproteinemia.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Apolipoproteins A / blood
  • Apolipoproteins B / blood
  • Cholesterol / blood
  • Clofibrate / therapeutic use*
  • Female
  • Humans
  • Hyperlipoproteinemia Type III / drug therapy*
  • Hyperlipoproteinemia Type IV / drug therapy*
  • Hypolipidemic Agents / therapeutic use*
  • Lipase / blood
  • Lipoprotein Lipase / blood
  • Lipoproteins / blood
  • Male
  • Middle Aged
  • Pyrazines / therapeutic use*
  • Triglycerides / blood


  • Apolipoprotein A-I
  • Apolipoprotein A-II
  • Apolipoproteins A
  • Apolipoproteins B
  • Hypolipidemic Agents
  • Lipoproteins
  • Pyrazines
  • Triglycerides
  • Cholesterol
  • Lipase
  • Lipoprotein Lipase
  • Clofibrate
  • acipimox