From Dr C. A. Conroy, MRPharmS
SIR,-The endorsement of octacosanol as a "useful supplement" in cholesterol lowering surprised me (PJ, July 29, p170). I refer to the authors' inclusion of a single-blind study by Pons et al reporting benefits of total cholesterol (TC) reduction in elderly hypercholesterolaemic patients treated with policosanol 1mg or 10mg (not 2mg as printed).1
This outcome measure is of little value in isolation. Reductions in TC can be attributed to decreases in high density lipo-protein cholesterol (HDL-C), therefore, one certainly cannot conclude that policosanol is "lipid-friendly".
With the advent of Cochrane, the need for scientifically rigorous studies has become evident. It is only then that informed decisions can be made by review of high quality studies which can report crucial efficacy measures.
Clare Conroy
R&D Pharmacist, Bristol Royal Infirmary
| 1. Pons P, Jimenez A, Rod-rigues M, Illnait J, Mas R, Fernandez L et al. Effects of policosanol in elderly hypercholesterolemic patients. Curr Ther Res 1993;53: 265-9. |
Dr G. B. LOCKWOOD and Mrs L. RAPPORT (authors of the article) reply: Within the context of the series of articles on nutraceuticals, we still consider that octacosanol is a useful supplement. No significant adverse effects are shown, and both animal and human studies showed positive lowering effects on LDL-C. We agree wholeheartedly that further research needs to be done, as stated in our conclusion. Total cholesterol (TC) reduction as shown by Pons et al was not the only work discussed in the article, and we did not base our conclusions on this alone. There are many more published papers which show similar results which are beyond the scope of the article for reasons of length.
We agree in general with the correspondent concerning the Cochrane Library, but in the case of octacosanol (policosanol), it has as yet produced no review on the subject, even though the particular paper by Pons et al is one of the 28 papers listed as a randomised control trial in the library's controlled trials register.
We apologise for the misquoted dosage of 2mg.