Comparative study of a microporous cholestyramine analogue (filicol) and gemfibrozil for treatment of severe primary hypercholesterolemia. Short- and long-term results.

Abstract

The hypolipidemic effect of gemfibrozil in severe hypercholesterolemia is not well established. Fifty patients with primary hypercholesterolemia (including 18 patients with familial hypercholesterolemia) and stable low-density lipoprotein cholesterol levels greater than 3.90 mmol/L (greater than 150 mg/dL) (6.10 +/- 1.30 [SD] mmol/L; 236 +/- 50 mg/dL) while on a hypolipidemic diet were assigned to treatment for 12 weeks with either 9 g/d of filicol, a microporous cholestyramine analogue, or 1.2 g/d of gemfibrozil in a randomized clinical trial. Tolerance was good with both drugs. Filicol and gemfibrozil caused similar decrements of total cholesterol (14% for both), low-density lipoprotein cholesterol (20% and 18%, respectively), and apolipoprotein B (16% and 21%, respectively). Close to 40% of the patients had decreases of greater than 25% in low-density lipoprotein cholesterol levels with both drugs. Gemfibrozil, but not filicol, significantly increased plasma high-density lipoprotein cholesterol (16%) and apolipoprotein A-I (17%) levels and reduced triglyceride levels (35%). No loss of efficacy was observed with either drug in subsets of patients who had a good 12-week response rate and had extended therapy for up to 12 months. This study demonstrates that gemfibrozil may have a beneficial effect on all aspects of the plasma lipid profile in patients with severe hypercholesterolemia, a clinical situation where it can be used with potential advantages over standard doses of anion-exchange resins.

• Authors: E Ros, D Zambón, A Bertomeu, E Cusó, C Sanllehy, E Casals
• Journal: Archives of internal medicine (Arch Intern Med) Vol. 151 Issue 2 Pg. 301-5 (Feb 1991) ISSN: 0003-9926 [Print] United States
• PMID: 1992957 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Apolipoproteins
• Cholesterol, HDL
• Cholesterol, LDL
• Triglycerides
• Cholestyramine Resin
• filicol
• Gemfibrozil

Topics

• Adult
• Aged
• Apolipoproteins (blood)
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Cholestyramine Resin (adverse effects, therapeutic use)
• Female
• Gemfibrozil (therapeutic use)
• Humans
• Hypercholesterolemia (blood, drug therapy)
• Male
• Middle Aged
• Prospective Studies
• Triglycerides (blood)