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

• Published in: Journal of clinical lipidology Vol. 9; no. 5; pp. 692 - 697
• Main Authors: Chen, Ya-qin, Zhao, Shui-ping, Zhao, Yu-hong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2015
• Subjects: Adolescent; Adult; Adverse effect; Aged; Cardiovascular; Coenzyme A; Coenzyme A - adverse effects; Coenzyme A - pharmacology; Coenzyme A - therapeutic use; Double-Blind Method; Dyslipidemia; Female; Humans; Hyperlipidemias - blood; Hyperlipidemias - drug therapy; Lipoproteins - blood; Male; Middle Aged; Non–high-density lipoprotein cholesterol; Pantetheine - adverse effects; Pantetheine - analogs & derivatives; Pantetheine - pharmacology; Pantetheine - therapeutic use; Safety; Treatment Outcome; Triglyceride; Triglycerides - blood; Young Adult; Coenzyme A; Triglyceride; Non–high-density lipoprotein cholesterol; Adverse effect; Dyslipidemia
• ISSN: 1933-2874; 1876-4789
• DOI: 10.1016/j.jacl.2015.07.003

New, safer, and more effective agents to treat hyperlipidemia and thereby prevent cardiovascular events are under research. 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. 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. 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. CoA can improve TG and other lipoprotein parameters to a greater extent than pantethine in moderate dyslipidemia, with no obvious adverse effects. •CoA can effectively reduce plasma triglyceride levels in subjects with moderate dyslipidemia.•CoA can improve triglyceride levels to a greater extent than pantethine.•CoA was associated with significant reductions in total cholesterol and non–high-density lipoprotein levels.•Both CoA and pantethine have no obvious adverse effect.