Ultra-small phospholipid nanoparticles in the treatment of combined hyperlipidemia: a randomized placebo-controlled clinical trial

Abstract

Background and purpose: Combined hyperlipidemia is associated with an increased risk of cardiovascular events. This clinical trial investigated phospholipovit (essential phospholipids, Institute of Biomedical Chemistry, Moscow, Russia), an ultra-small phospholipid nanoparticle (micelles), targeted to phospholipids of HDL in lowering non-HDL-cholesterol (non-HDL-C) and triglycerides (TG) levels in patients with combined hyperlipidemia and moderate cardiovascular risk.

Experimental approach: A randomized, double-blinded, placebo-controlled phase II trial was conducted on 100 patients. Phospholipovit or placebo was randomly administered orally (500 mg) 2 times a day for 12 weeks. The primary endpoint was the percent change of non-HDL-C from baseline to 12 weeks of exposure.

Findings/results: Treatment with phospholipovit resulted in a mean non-HDL-C reduction of 13.2% versus 4.3% compared with placebo. The absolute decrease in non-HDL-C was -23.2 (-48.7 - 7.0) mg/dL versus -7.3 (-17.0 - 12.0) mg/dL, significantly. The therapeutic target of non-HDL-C less than 130 mg/dL (3.4 mmol) was achieved in 15 of 39 patients (38.5%) in the phospholipovit group versus 2 of 41 patients (4.9%) in the placebo group OR 11.8 (2.4 - 116). Significant reduction in TG, apolipoprotein B, total cholesterol, and very low-density lipoprotein cholesterol levels was also observed. There were no changes in the liver and kidney functions, vital signs, or electrocardiography. There were no serious adverse events.

Conclusion and implications: Phospholipovit significantly reduced non-HDL-C, TG, and atherogenic lipoproteins in patients with combined hyperlipidemia and moderate cardiovascular risk. It can be used as an add-on therapy to statins.

Keywords: Combined hyperlipidemia; Non-HDL-C; Phospholipid nanoparticles (micelles); TG.

Fig. 1

Trial flow diagram. Phospholipovit or placebo (maltose) was administered orally at 500 mg, 2 times /day for 12 weeks.

Fig. 2

The changes of biochemical parameters including (A) TG, non-HDL-C, TC, ApoB, and VLDL-C and (B) HDL-C, LDL-C, ApoA, Lp (a), and hs-CRP in phospholipovit and placebo groups. Phospholipovit or placebo (maltose) was administered orally at 500 mg, 2 times/day for 12 weeks. Data were presented as median and its confidence intervals. *P < 0.05 indicated a significant difference compared with the placebo group. TG, Triglycerides; TC, total cholesterol; ApoB, apolipoprotein B; VLDL-C, very-low-density lipoproteins-cholesterol; HDL-C, high-density lipoproteinscholesterol; LDL-C, low-density lipoproteins-cholesterol; ApoA, apolipoprotein A; Lp (a), lipoprotein (a); hs-CRP, high-sensitivity C-reactive protein.