Source: Dermatology  |  Posted 4 years ago

By Danny Kucharsky

NEW ORLEANS, LA -- March 26, 2007 -- Gemfibrozil treatment significantly reduces triglycerides, raises levels of high-density lipoprotein (HDL) cholesterol with reasonable safety in children with severe metabolic syndrome, according to a retrospective study as presented here at the 56[^]th[] annual scientific session of the American College of Cardiology (ACC).

Gemfibrozil also significantly reduced levels of alanine transferase (ALT) and aspartate transferase (AST) levels in this population, said investigator Courtney Smalley, medical student, University of Arizona, Tucson, Arizona, United States.

"This is a drug that is widely used in adults," but it has not been studied in children until now, she noted in her presentation on March 25[^]th[].

The study investigated the effects of gemfibrozil on levels of triglycerides and HDL cholesterol and its adverse events in 55 paediatric patients with severe metabolic syndrome.

The study involved 55 pediatric patients who took gemfibrozil 1,200 mg/daily along with diet and exercise. Forty patients with a median age of 13 years were in the intervention group. Mean duration of treatment was 249 days.

Thirty patients in the intervention group (7.5%) had evidence of non-alcoholic steatohepatitis as determined by elevated levels of ALT/AST or biopsy, or both. On treatment mean triglyceride levels decreased by 54%: 388 mg/dL to 179 mg/dL (SE =33.3 vs 18; []P[] < .0001).

Mean HDL level increased significantly by 17% from 36 mg/dL to 42 mg/dL ([]P[] < .001). As well, mean liver enzymes -- ALT and AST -- decreased from 57 to 35 IU/L (38%) and 39 to 28 IU/L (28%), respectively ([]P[] = .001, []P[] = .006). "What was surprising was the decrease in ALS and ALT," Smalley said.

Body mass index, waist circumference and body fat level did not change significantly, which indicates that the reduction in triglyceride levels and the increase in HDL can be attributed to gemfibrozil. There were 2 patients with adverse events -- muscle pains -- who were withdrawn from the study.

"These patients are developing excess fat in their livers," noted another investigator, Dr. Stanley Goldberg, professor emeritus at the University of Arizona School of Medicine, Tucson, Arizona. "If we can reduce that excess fat it will be beneficial."

[Presentation title: Treatment of Severe Metabolic Syndrome With Gemfibrozil in a Pediatric Population. Abstract 1005-27]