Re: More on Statins

x-no-archive: yes

Tom wrote:

A very interesting thread and particularly your comment Susan.

I'm over 70 now and type 1 and on insulin for 50 years. I was
transferred to a new diabetic clinic and it was explained to me there
that all their paitients who were 50 plus were automatically put on
statins. I wasn't going to be as I had a friend who suffered greatly
when put on the drug. To say the hospitals reaction was hostile was
putting in mildly as was my own doctor's.

In the UK as far as I understand, doctors and hospitals have targets
to meet. If they test a patient and there cholesterol level is above
the set target then they don't get additional bonuses from the local
health authority until the level comes down to or below the already
mentioned target figure. In my mind that is why statins are being
thrown by the bucket-load to patients. It begs the question as to
whose benefit statin use is for. The drug companies must be rubbing
their hands with glee.

Personally I use a very cheap combination of Vitamin C, Proline and L-
Lysine (from my local health food shop) and have watched my
cholesterol level drop from 5.6 to 4.9 over the last 5 months. I'll
keep taking them until I get the figure down to 4.6, the level quoted
by my doctor.


U.S. docs earn percs by rxing certain high cost on patent drugs over older, less profitable ones, too. It's a triumph of marketing over individualized patient treatment plans. :-/

Tom, have you ever seen these?:

[Evaluation of the cholesterol-lowering effectiveness of pantethine in women in perimenopausal age]

[Article in Italian]

Binaghi P, Cellina G, Lo Cicero G, Bruschi F, Porcaro E, Penotti M.

Servizio di Cardiologia, Istitut Clinici di Perfezionamento, Milano.

Cardiovascular diseases are the main cause of death also in women. Their incidence, rapidly growing in the peri-menopausal period, is related to serum levels of total cholesterol and its LDL fraction. It was also shown that the peroxidation of LDL is an additional factor in the genesis of atherosclerotic vascular disease. As long-term treatments with synthetic lipid-lowering drugs may cause undesirable side effects, while pantethine is known to be well tolerated, we treated 24 hypercholesterolemic women (total serum cholesterol greater than or equal to 240 mg/dl), in perimenopausal age (range: 45-55 years, mean +/- SD = 51.6 +/- 2.4) with 900 mg/day of pantethine. This is a precursor of coenzyme A, with an antiperoxidation effect in vivo, and our aim was to confirm its lipid lowering activity in this particular type of patients. After 16 weeks of treatment, significant reductions of total cholesterol, LDL-cholesterol and LDL-C/HDL-C ratio could be observed. No remarkable changes of the main laboratory parameters (fasting blood sugar, B.U.N., creatinine, uric acid) were seen. Efficacy percentages of the treatment were about 80%. None of the patients complained of adverse reactions due to the treatment with pantethine. In conclusion, we suggest that pantethine should be considered in the long-term treatment of lipid derangements occurring in the perimenopausal age.

PMID: 2359503 [PubMed - indexed for MEDLINE]
1: Acta Biomed Ateneo Parmense. 1984;55(1):25-42. Related Articles, Links


[Hyperlipidemia, diabetes and atherosclerosis: efficacy of treatment with pantethine]

[Article in Italian]

Arsenio L, Caronna S, Lateana M, Magnati G, Strata A, Zammarchi G.

The hypolipidemizing effects of Pantethine were investigated by the Authors in 37 hypercholesterolemic and/or hypertriglyceridemic patients. Of these, 21 were also diabetic, in a satisfying glucidic compensation, in order to verify the action of this drug also in this metabolic condition. The study was carried out for three months and during this period the patients were given Pantethine at the dose of 600 mg/die orally. At the 30th, the 60th, the 90th day of treatment the following parameters were controlled: cholesterolemia, HDL cholesterol, apolipoproteins A and B, triglyceridemia, systolic and diastolic arterial pressure, uricemia, body weight. Thirty days after suspending the treatment, the parameters were controlled again to detect a possible "rebound" effect. The results were analyzed on the whole case-record, subdividing the patients in dislipidemic and diabetic-dislipidemic, and on the basis of the Fredrickson's classification. Pantethine induced in all groups a quick and progressive decrease of cholesterolemia, triglyceridemia, LDL cholesterol and Apolipoproteins B with increased HDL cholesterol and Apolipoproteins A. After suspending the treatment, there is a clear inversion of the state of these parameters. The Authors conclude that the present work shows that Pantethine, a natural and atoxic substance, an important component of Coenzyme A, is efficacious in determining a clear tendency towards normalization of the lipidic values.

PMID: 6232801 [PubMed - indexed for MEDLINE]
1: Atherosclerosis. 1984 Jan;50(1):73-83. Related Articles, Links


Controlled evaluation of pantethine, a natural hypolipidemic compound, in patients with different forms of hyperlipoproteinemia.

Gaddi A, Descovich GC, Noseda G, Fragiacomo C, Colombo L, Craveri A, Montanari G, Sirtori CR.

Pantethine (P), the stable disulphate form of pantetheine, major component and precursor of coenzyme A, was evaluated within a double-blind protocol (8 weeks for P or for a corresponding placebo) in 29 patients, 11 with type IIB hyperlipoproteinemia, 15 with type IV, and 3 with an isolated reduction of high density lipoprotein cholesterol (HDL-C) levels. In type IIB patients, P (300 mg t.i.d.) determined a highly significant lowering of plasma total and low density lipoprotein (LDL) associated cholesterol (-13.5% for both parameters). In the same patients, HDL-C levels increased about 10% at the end of treatment. Switching from P to placebo was associated with a rapid return to the baseline cholesterolemia. Both in type IIB and type IV patients, plasma triglyceride levels were reduced around 30%, when P was given as the first treatment; when it was preceded by placebo, reductions were less striking (respectively, -17.8% for type IIB and -13.0% for type IV, at the end of P treatment). HDL-C levels were not increased by P, either in type IV, and in the patients with low HDL cholesterolemia. In type IV, LDL cholesterol levels showed a variable response to P: they tended to increase when below 132 mg/dl, prior to treatment, and to be reduced when above this level. This study provides evidence for a significant hypocholesterolemic effect of P, a natural compound free of overt side effects. It also indicates that P may raise HDL-C levels in type IIB patients, while moderately reducing triglyceridemia.

Publication Types:
• Clinical Trial
• Controlled Clinical Trial

PMID: 6365107 [PubMed - indexed for MEDLINE]
1: Int J Clin Pharmacol Ther Toxicol. 1986 Nov;24(11):630-7. Related Articles, Links


Lipoprotein changes induced by pantethine in hyperlipoproteinemic patients: adults and children.

Bertolini S, Donati C, Elicio N, Daga A, Cuzzolaro S, Marcenaro A, Saturnino M, Balestreri R.

Following a brief outline of current knowledge concerning atherosclerosis and its treatment, the authors describe the results obtained by treating with pantethine (900-1200 mg daily for 3 to 6 months) a series of 7 children and 65 adults suffering from hypercholesterolemia alone or associated with hypertriglyceridemia (types IIa and IIb of Fredrickson's classification). Pantethine treatment produced significant reduction of the better known risk factors (total cholesterol, LDL-cholesterol, triglycerides, and apo-B) and a significant increase of HDL-cholesterol (signally HDL2) and apolipoprotein A-I. The authors conclude with a discussion of these results and of the possible role of pantethine in the treatment of hyperlipoproteinemia, in view of its perfect tolerability and demonstrated therapeutic effectiveness.

PMID: 3098691 [PubMed - indexed for MEDLINE]
: Atherosclerosis. 1984 Dec;53(3):255-64. Related Articles, Links


Pantethine reduces plasma cholesterol and the severity of arterial lesions in experimental hypercholesterolemic rabbits.

Carrara P, Matturri L, Galbussera M, Lovati MR, Franceschini G, Sirtori CR.

Pantethine (P), a coenzyme A precursor, was administered to cholesterol-fed rabbits (0.5% cholesterol diet + 1% pantethine) for 90 days. At the end of treatment, plasma total cholesterol levels were reduced 64.7% and the HDL/total cholesterol ratio increased in P-treated animals; a significant rise of the apo A-I/A-II ratio was detected in HDL. VLDL lipid and protein levels were, on the other hand, reduced by P. The cholesterol-ester content of both liver and aortic tissues was not significantly affected by P. Although the total aortic area with evident plaques was reduced only 18.2%, the microscopical examination of sections from the major vessels of P-treated animals, showed a reduction in the severity of lesions, both in the aorta and in the coronary arteries. These findings suggest that P, in addition to significantly lowering plasma cholesterol levels in rabbits on an experimental diet, may modify lipid deposition in major arteries, possibly by affecting lipoprotein composition and/or exerting an arterial protective effect.

PMID: 6442152 [PubMed - indexed for MEDLINE]
Clin Ther. 1986;8(5):537-45. Related Articles, Links


Effectiveness of long-term treatment with pantethine in patients with dyslipidemia.

Arsenio L, Bodria P, Magnati G, Strata A, Trovato R.

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.

PMID: 3094958 [PubMed - indexed for MEDLINE]
Acta Biomed Ateneo Parmense. 1987;58(5-6):143-52. Related Articles, Links


[Clinical use of pantethine by parenteral route in the treatment of hyperlipidemia]

[Article in Italian]

Arsenio L, Bodria P, Bossi S, Lateana M, Strata A.

Servizio di Malattie del Ricambio e Diabetologia, Ospedali Riuniti, Parma.

Recent investigations have confirmed the effectiveness and the excellent tolerability of pantethine, a derivative of pantetheine, an essential part of the acetylation coenzyme CoA, administered P.O., in normalizing the blood lipid concentrations of patients with hyperlipidemias. A group of 18 patients with hyperlipidemias (9 M, 9 F), with an average age of 52.6 years, was submitted to pantethine parenteral treatment. After a 20 days wash-out, pantethine (400 mg/day; BID) was administered intramuscularly, for 20 days. Total cholesterol, triglycerides, HDL-cholesterol, apo A-1 and B lipoprotein, uric acid in serum, glycemia, CBC, B.U.N., creatininemia, E.S.R., SGOT, SGPT, bilirubinemia, cardiac frequency, blood pressure and body weight were controlled before and after treatment. The drug showed to have a therapeutic effectiveness by a rapid and significant improvement in the blood lipid pattern with reduction of total cholesterol, triglycerides and apo-B lipoprotein and increase of HDL-cholesterol and apo A-1 lipoprotein. The tolerability of pantethine at the stated dosage and mode of administration was invariably excellent, with non complaints or visible side effects imputable to the test drug. BUN, creatininemia, glycemia, SGOT, SGPT, bilirubinemia, E.S.R., CBC, cardiac frequency and blood pressure readings showed no noteworthy changes throughout the study.

PMID: 2970754 [PubMed - indexed for MEDLINE]

1: Vopr Pitan. 1987 Mar-Apr;(2):15-7. Related Articles, Links


[Therapeutic efficacy of pantothenic acid preparations in ischemic heart disease patients]

[Article in Russian]

Borets VM, Lis MA, Pyrochkin VM, Kishkovich VP, Butkevich ND.

The therapeutic effectiveness of the pantothenic acid drugs: calciipantothenas and pantethine, was studied in 182 patients with coronary heart disease and stable angina of effort. It is shown that both the drugs produce favourable effects on certain parameters of hemodynamics, on the metabolism of lipids, riboflavin and ascorbic acid. It is recommended that the administration of calciipantothenas in a dose of 300 mg/day, during 3 weeks, be included into the combined treatment of coronary patients with no manifest disorders of lipid metabolism. Patients with manifest hyperlipidemia should be administered pantethine in a dose of 500 mg/day.

PMID: 3590676 [PubMed - indexed for MEDLINE]

1: Clin Nephrol. 1986 Feb;25(2):70-4. Related Articles, Links


Pantethine improves the lipid abnormalities of chronic hemodialysis patients: results of a multicenter clinical trial.

Donati C, Barbi G, Cairo G, Prati GF, Degli Esposti E.

In the course of a post-marketing surveillance program on the effectiveness and tolerability of pantethine in the treatment of hyperlipidemia, the effects of the drug were explored in 31 patients with dyslipidemia undergoing chronic hemodialysis. The mean duration of treatment was 9 months (min. 7 months, max. 24 months), with oral doses of 600 to 1200 mg of pantethine daily (mean daily dosage 970 mg). Improvement was noted in terms of total blood cholesterol in the 7 patients with basal hypercholesterolemia (p less than 0.01) and highly significant reduction of serum triglycerides. No variations of HDL-cholesterol or total Apo-A were detected. None of the patients experienced any adverse effects from the treatment. In the light of extensive experience with the drug, plus the results of this study, the authors conclude by stressing the importance of an effective and readily tolerated product, such as pantethine, for the treatment of dyslipidemia in patients on chronic hemodialysis.

Publication Types:
• Clinical Trial

PMID: 3516477 [PubMed - indexed for MEDLINE]
1: Artery. 1987;15(1):1-12. Related Articles, Links


Lowering effect of pantethine on plasma beta-thromboglobulin and lipids in diabetes mellitus.

Eto M, Watanabe K, Chonan N, Ishii K.

Second Department of Internal Medicine, Asahikawa Medical College, Japan.

Pantethine in a dosage of 600 mg for the first 3 months, and in a dosage of 1200 mg for the second 6 months was given to 16 diabetics in whom plasma beta-thromboglobulin was raised (greater than 50 ng/ml). Plasma beta-TG levels decreased significantly with pantethine treatment for 9 months. Plasma triglyceride, total cholesterol, apo E and apo CII levels decreased significantly after 9 months. Plasma LDL-C and atherogenic index (LDL-C/HDL-C ratio or apo B/apo AI ratio) tended to decrease with treatment. It is concluded that administration of pantethine may be beneficial in the prevention of diabetic angiopathy because of its lowering effect on plasma beta-TG, lipids and apolipoproteins.

PMID: 2963604 [PubMed - indexed for MEDLINE]
1: Ter Arkh. 1991;63(11):58-60. Related Articles, Links


[The use of pantothenic acid preparations in treating patients with viral hepatitis A]

[Article in Russian]

Komar VI.

Calcium pantothemate in the daily dose 300 mg and 600 mg and pantetheine in the dose 90 mg and 180 mg per os were applied for 3-4 weeks in combined therapy of 156 patients with viral hepatitis A. In addition to the positive clinico-biochemical effect, these drugs produced an immunomodulatory action and a beneficial effect on the level of blood serum immunoglobulins and the phagocytic activity of peripheral blood neutrophils. Pantetheine provided the most pronounced therapeutic effect.

PMID: 1810066 [PubMed - indexed for MEDLINE]
1: Clin Ter. 1989 Mar 31;128(6):411-22. Related Articles, Links


[Pantethine, diabetes mellitus and atherosclerosis. Clinical study of 1045 patients]

[Article in Italian]

Donati C, Bertieri RS, Barbi G.

After a review of the clinical studies on the treatment of diabetic patients with pantethine, the authors discuss the results obtained in a postmarketing surveillance (PMS) study on 1045 hyperlipidemic patients receiving pantethine (900 mg/day on average). Of these patients, 57 were insulin-dependent (Type I) and 241 were non insulin-dependent (Type II) diabetics. Beyond the epidemiological considerations made possible by a PMS study, the authors show that pantethine brought about a statistically significant and comparable improvement of lipid metabolism in the three groups of patients, with very good tolerability. Pantethine should therefore be considered for the treatment of lipid abnormalities also in patients at risk such as those with diabetes mellitus.

PMID: 2524328 [PubMed - indexed for MEDLINE]
1: Vopr Pitan. 1983;(1):45-9. Related Articles, Links


[Pantothenic acid metabolic disorder and its relation to the change in energy processes in patients with ischemic heart disease and hypertension]

[Article in Russian]

Borets VM, Ovchinnikov VA, Mironchik VV, Moiseenok AG, Lis MA.

Pantothenic acid metabolism and the status of energy processes in leukocytes were examined in 171 patients with hypertension and coronary heart disease. It was shown that the patients' body supply with the vitamin decreased as the disease progressed and heart failure supervened. The deficiency of pantothenic acid was shown to be interrelated with the impairment of energy processes. Application of pantothenate in a dose of 200 mg a day for two weeks led to the increased content of pantothenic acid and to normalization of energy processes.

PMID: 6837001 [PubMed - indexed for MEDLINE]
1: Angiology. 1987 Mar;38(3):241-7. Related Articles, Links


Effect of oral treatment with pantethine on platelet and plasma phospholipids in IIa hyperlipoproteinemia.

Prisco D, Rogasi PG, Matucci M, Paniccia R, Abbate R, Gensini GF, Neri Serneri GG.

In a single-blind, crossover, completely randomized study, the effects of oral treatment with pantethine or placebo on fatty acid composition of plasma and platelet phospholipids were investigated in 10 IIa hyperlipoproteinemic patients. A significant decrease of total cholesterol and total phospholipids was observed both in plasma and in platelets after a twenty-eight-day treatment. In plasma, pantethine induced a decrease of the ratio sphingomyelin/phosphatidylcholine. Moreover, a relative increase of n3-polyunsaturated fatty acids both in plasma and in platelet phospholipids and a decrease of arachidonic acid in plasma phospholipids were observed. These results indicate that pantethine can affect plasma and platelet lipid composition with possibly favorable influences on the determinants of cell membrane fluidity.

Publication Types:
• Clinical Trial
• Randomized Controlled Trial

PMID: 3551695 [PubMed - indexed for MEDLINE]



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