Background: Hypertriglyceridemia is one of the risk factors for cardiovascular disease, and reduction of triglyceride (TG) level is recommended in clinical practice guidelines for the treatment. Recently, andrographolide, a main active compound of Andrographis paniculata has been shown to possess hypolipidemic effects in animals.
Objective: To investigate the TG-lowering effects of A. paniculata extract (APE) in patients with hypertriglyceridemia (TG >150 mg/dL) using gemfibrozil treatment as the reference.
Material and Method: A randomized controlled clinical trial was carried out in sixty subjects with hypertriglyceridemia. They
were divided into three groups and treated with low dose of APE (APE-L, andrographolide 71.64-72.36 mg/day), high dose of APE (APE-H, andrographolide 119.64-120.36 mg/day), and gemfibrozil 300 mg/day. The treatments were conducted for
8 weeks. Guidance on lifestyle modifications was provided.
Results: The primary end point was the mean difference +SD (95% CI) in TG levels (baseline from the end of treatment),
which were -3+125.6 (-59.1, 58.5), 41.6+86.3 (1.2, 82), and 57.1+94.9 (12.7, 101.6) in the APE-L, APE-H, and gemfibrozil
groups, respectively. APE-H 120 mg/day and gemfibrozil 300 mg/day caused a significant reduction of TG level (p = 0.0442
and 0.0145, respectively) when compared to the baseline. There was no notable difference in the safety or tolerability among the treatment groups.
Conclusion: In patients with modest hypertriglyceridemia with lifestyle intervention, APE-H reduced the TG level comparable
to the effect of gemfibrozil 300 mg/day. APE treatment was as tolerable as gemfibrozil treatment. Hence, Andrographis
paniculata might be used as an alternative medicine in treating hypertriglyceridemic patients.

Keywords: Hypertriglyceridemia, Andrographis paniculata, Andrographolide, Gemfibrozil