A comparative study of policosanol versus probucol in patients with hypercholesterolemia

Abstract

Thirty patients with type II primary hypercholesterolemia were enrolled in a randomized, double-masked, parallel, comparative study of policosanol—a newer cholesterol-lowering agent obtained from sugar cane wax—and probucol. Prior to randomization, all patients started or continued on a standard, first-step cholesterol-lowering diet for 6 weeks. Patients were randomized to receive either policosanol (5 mg twice daily) or probucol (500 mg twice daily) for 8 weeks. Both groups were similar at randomization. With policosanol, total cholesterol, low-density lipoprotein cholesterol (LDL-C), and triglycerides decreased significantly by 18.0%, 22.7%, and 16.2%, respectively. In addition, policosanol significantly lowered the ratios of total cholesterol:high-density lipoprotein cholesterol (HDL-C) and LDL-C:HDL-C, by 20.8% and 25.5%, respectively. Probucol significantly lowered total cholesterol (7.8%) and LDL-C (11.8%), as well as the ratios of LDL-C:HDL-C (15.0%) and total cholesterol:HDL-C (11.4%). Neither policosanol nor probucol treatment significantly changed HDL-C levels. Both drugs were well tolerated; no patient withdrew from the trial. Adverse experiences reported were mild and did not differ significantly between groups. It is concluded that both drugs are adequate alternatives for treating patients with type II hypercholesterolemia, with policosanol being more effective than probucol in this short-term study.