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  • 1
    ISSN: 1432-1440
    Keywords: Hyperlipidaemia ; Cholesterol ; Triglycerides ; Uraemia ; Regular haemodialysis treatment ; Bezafibrate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Hyperlipidaemia may contribute to the high rate of cardiovascular complications in patients on chronic haemodialysis (CHD). However, possibilities of lipid lowering therapy in CHD are still limited. The applicability of bezafibrate (BF), a recently developed clofibrate analogue, was investigated in patients on CHD with triglyceride and/or total cholesterol levels above 300 mg/dl. The lipid lowering effect was studied in a placebo-controlled trial over 6 months in 19 patients. Long-term effect was followed in six patients over a mean period of 29 months. Elimination half-life and mean therapeutic serum concentration were calculated by 72-h BF serum profiles, obtained after the first drug administration of a single 200-mg dose and during steady state after 12 weeks of treatment. Elimination half-lives were 17 h at start and 22 h after 12 weeks compared with 2 h in subjects with normal renal function. Dose reduction to 200 mg every 3rd day was necessary and resulted in a mean therapeutic serum concentration of 3.4 mg/l, which was similar to 3.0 mg/l of normal subjects, who received the dose optimal for lowering of lipids (200 mg 3 × /day). The protein-bound serum fraction of BF was decreased to 8% in CHD patients, compared with 95% found in normal subjects. BF therapy resulted in a marked reduction of serum triglycerides from 478 mg/dl by 31% and total cholesterol levels from 311 mg/dl by 19% as well as β-Lp-cholesterol from 178 mg/dl by 17%, whereas the initially low α-Lp-cholesterol increased significantly from 18,3 mg/dl by 58%. Under long-term therapy not only continuously low triglyceride and cholesterol levels could be maintained, moreover a further decline (−20% and −7%) could be achieved. Safety laboratory controls, comprising haemoglobin, bilirubin, liver enzymes, CK and albumin, showed no significant changes apart from a slight reversible increase in CK and a decrease in gamma-GT and alkaline phosphatase. Subjective side effects were not reported. Under this dosage schedule, BF therapy was thus effective and safe, improving potentially atherogenic disturbances of lipid metabolism.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Journal of molecular medicine 58 (1980), S. 889-896 
    ISSN: 1432-1440
    Keywords: Bezafibrat ; Niereninsuffizienz ; Pharmakokinetik ; Dosierungsschema ; Renale Clearance ; Extrarenale Clearance ; Bezafibrate ; Pharmacokinetics ; Dosage scheme ; Renal failure ; Renal clearance ; Extrarenal clearance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary The pharmacokinetics of bezafibrate were investigated in the serum and urine of 22 patients with impaired renal function of different degrees after a single oral dose. The results of the first study were checked by a second study in another 12 patients with advanced renal insufficiency using multiple dosing. Both studies revealed an almost identical hyperbolic relationship between the mean serum concentration over 24 h and the endogenous creatinine clearance. Since the vertex of this hyperbola is positioned at a creatinine clearance of 50 ml/min, only greater impairment of the renal function requires dose reduction, the respective nomograms and schedules for which are given. Even in advanced renal failure (creatinine clearance 10–25 ml/min) the total serum clearance of bezafibrate was considerably higher (27 ml/min) than that reported in the literature for clofibric acid. It is of interest to note that not only the renal but also the “extrarenal” clearance, which in normals accounts for approximately half of the total clearance of bezafibrate, was considerably depressed in advanced renal failure. This might indicate that part of the extrarenal mechanism of bezafibrate elimination, e.g. the glucuronidation, might occur in the kidneys. Knowledge of the kinetic behaviour of bezafibrate in patients with impaired renal function also allows rational therapy in the presence of this condition.
    Notes: Zusammenfassung Die Pharmakokinetik von Bezafibrat wurde in Serum und Urin von 22 Patienten mit unterschiedlich eingeschränkter Nierenfunktion nach einmaliger oraler Gabe untersucht. Die hierbei gewonnenen Ergebnisse wurden in einer zweiten Studie bei 12 weiteren Patienten (Kreatinin Clearance 10–25 ml/min) unter steady-state-Bedingungen überprüft. Beide Studien ergaben eine nahezu identische hyperbole Beziehung zwischen der mittleren Serumkonzentration über 24 h und der endogenen Kreatinin-Clearance. Da der Scheitel dieser Hyperbel bei einer Kreatinin-Clearance von ca. 50 ml/min, liegt, ist eine Dosis-Reduktion erst bei weitergehender Einschränkung der Nierenfunktion erforderlich. Entsprechende Nomogramme und Dosisempfehlungen werden angegeben. Selbst bei fortgeschrittener Niereninsuffizienz (Kreatin-Clearance 10–25 ml/min) ist die totale Clearance des Bezafibrats noch mehrfach höher (27 ml/min) als die in der Literatur unter vergleichbaren Bedingungen für Clofibrinsäure bestimmte. Interessanterweise ist nicht nur die renale, sondern auch die extrarenale Clearance von Bezafibrat, die normalerweise ca. die Hälfte der totalen Clearance ausmacht, bei fortgeschrittener Niereninsuffizienz deutlich vermindert. Dies weist darauf hin, daß ein Teil der „extrarenalen“ Eliminationsmechanismen des Bezafibrat, z.B. der Umsatz zu Glucuronsäurekonjugaten auch in der Niere ablaufen dürfte. Insgesamt erlaubt nun die Kenntnis der Pharmakokinetik des Bezafibrat bei Niereninsuffizienz eine rationale Therapieführung bei derartigen Patienten.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 16 (1979), S. 31-38 
    ISSN: 1432-1041
    Keywords: bezafibrate ; hyperlipoproteinemia ; bioavailability ; pharmacokinetics ; GC-MS
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary The disposition kinetics of bezafibrate, a newly developed drug of great lipid-lowering potency, were investigated in normal male subjects. Five male volunteers received14C-labelled bezafibrate orally in solution, and a further 10 were given the same dose (300 mg) of un-labelled drug as tablets. The concentration of bezafibrate in serum and urine from the latter was determined by GC, and in the former total radioactivity in serum, urine and feces was followed for 48 h, and urinary excretion products were analysed by TLC and GC-MS. Rapid absorption from the gastrointestinal tract led to peak serum levels 30 min and 2 h after administration of solution and tablets, respectively. Since approximately 95% of the administered14C-bezafibrate was excreted in urine within 48 h, and almost all the remainder was detected in feces, absorption can be regarded as complete after administration in solution. The relative optimal bioavailability from the tablets was also complete, since in both cases approximately 50% of the administered dose was detected as unchanged bezafibrate in urine within 24 h by GC in the tablet study, and by TLC in the solution study. Of the decomposition products, more than 20% of the dose was present as glucuronides and the remainder consisted of several more polar compounds, one of which was identified as a hydroxyderivative of bezafibrate. Since the apparent halflife of bezafibrate in serum was 2.1 h, this new drug possesses favourable pharmacokinetic features: rapid and complete absorption, even from tablets, combined with a conveniently short half-life, and clearance which is half renal (56 ml/min) and half metabolic (43 ml/min), giving a total clearance of 99 ml/min.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    European journal of clinical pharmacology 10 (1976), S. 147-149 
    ISSN: 1432-1041
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1432-1041
    Keywords: Dyslipidaemia ; Hypertension ; Captopril ; Carvedilol ; lipids ; diet
    Source: Springer Online Journal Archives 1860-2000
    Topics: Chemistry and Pharmacology , Medicine
    Notes: Summary We have studied 250 patients with mild to moderate essential hypertension (diastolic blood pressure 95 – 114 mmHg) and dyslipidaemia (high-density lipoprotein cholesterol (HDL-C) below 1.03 mmol·l−1, total cholesterol 5.17–9.05 mmol·l−1, and triglycerides 2.26–5.64 mmol·l−1) in a controlled double-blind, multicentre, parallel group trial. The patients took a fat-modified diet. After a 4-week placebo period, patients who continued to fulfil the selection criteria were randomly allocated to treatment with either carvedilol (a vasodilating β-blocker) 25–50 mg o.d. (n=116) or captopril (an ACE inhibitor) 25–50 mg o.d. (n=117) for 6 months. In both groups there were favourable effects on the serum lipids. The relative changes (medians) in the carvedilol and captopril group were respectively: increase in HDL-C by 11% and 8%, decrease in total cholesterol by 11% and 10%, in low-density lipoprotein cholesterol by 16% and 12%, and in triglycerides by 13% and 14%. Equivalence of the two treatments was confirmed for the target variable change in HDL-C at a significance level of 5%. Reductions in supine systolic/diastolic blood pressures were comparable in the two groups (carvedilol: 23/19 mmHg, captopril: 20/18 mmHg). The improvement in lipid metabolism in patients treated with carvedilol is probably due to its α1-blocking properties.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 180 (1982), S. 95-98 
    ISSN: 1433-8580
    Keywords: Bezafibrate ; Hyperlipoproteinemia ; Creatinine excretion ; Muscular proteins
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The effect of bezafibrate (200 mg t.i.d.) on renal and, to some degree, on muscular function was studied in nine patients with primary hyperlipoproteinemia. No signs of a reduction in creatinine excretion or an increase in muscular proteins could be found serving as a possible explanation for the slight increase in serum creatinine observed in a bezafibrate long-term study in more than 1,000 patients. Further studies are necessary for clarification.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1433-8580
    Keywords: Adipose fatty acids ; Blood lipids ; Glucose tolerance ; Coronary angiography
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Forty-eight patients with symptoms of angina pectoris were studied for adipose tissue fatty acid composition and cardiovascular risk factors while hospitalized for selective coronary angiography. Patients with manifest diabetes mellitus and deviations from the “normal” customary diet were excluded. Pairwise comparison between the groups with absent, slight, moderate, and severe coronary arteriosclerosis showed reasonable comparability for age, relative body weight, and skinfold measurements. The proportion of smokers, but not of hypertensives, showed a significant positive relationship with the degree of arteriosclerosis. Serum cholesterol was similar in all four groups, while triglycerides were clearly, but not significantly (P〉0.05) higher in patients with coronary arteriosclerosis. The oral glucose tolerance test (OGTT) index was significantly higher in moderate and severe disease. Significantly higher proportions for palmitic acid and lower proportions for linoleic acid were also found in these two groups. Multiple linear regression analysis showed a positive association with coronary arteriosclerosis for: OGTT index 〉 palmitic acid 〉 arachidonic acid 〉 triglycerides. The close negative association between the proportion of stearic acid in adipose tissue and coronary heart disease observed in two previous studies could not be confirmed. On the basis of the present study, stearic acid correlates with age rather than with arteriosclerotic disease.
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Research in experimental medicine 186 (1986), S. 435-441 
    ISSN: 1433-8580
    Keywords: Diurnal lipid profiles ; Hypertriglyceridemia ; Bezafibrate ; Clofibrate
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Thirty hypertriglyceridemic patients were treated under metabolic ward conditions for 10 days with either placebo, clofibrate (500 mg t.i.d.) or bezafibrate (200 mg t.i.d.) in a randomized, double-blind study. In addition, patients received an isocaloric prudent diet. On day 10 a diurnal lipid and lipoprotein profile was carried out. Compliance to medication was good. Each treatment led to significant reductions of fasting triglycerides and cholesterol. Lowering of fasting and integrated diurnal triglycerides was greatest with bezafibrate. HDL-cholesterol profiles were highest with this drug. A strong correlation between fasting and diurnal triglycerides was observed. Triglyceride-lowering therapy must therefore aim at fasting triglyceride values as low as possible.
    Type of Medium: Electronic Resource
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