The efficacy of an
anion-exchange gel, Secholex, as a hypocholesterolemic agent was assessed in 46 patients in 4 different studies and the effects were compared with those of
cholestyramine. All patients had severe Type II-a or II-b
hyperlipoproteinemia. In short-term metabolic studies Secholex (15 g/day) and
cholestyramine (16 g/day) decreased serum
cholesterol levels and increased total fecal
sterol output and serum methyl
sterol concentration to a similar extent, but
cholestyramine was more effective than Secholex in increasing fecal
bile acid excretion. In crossover studies, the two drugs appeared to be equally effective in lowing serum
cholesterol levels but the patients mostly preferred Secholex. Twenty patients were treated with Secholex over a two-year period. The average decrease in serum
cholesterol levels from the mean pretreatment value of 406 mg/100 ml was 15% during the first year, and 13% during the second year. In 5 patients the serum
cholesterol was permanently lowered by more than 20% (good responders), while in 7 patients the average reduction of serum
cholesterol level during Secholex administration was less than 10% (non-responders). The serum
triglyceride level was slightly decreased by Secholex in Type II-b patients but was unaltered in Type II-a patients. At the end of the treatment period, serum
iron and
vitamin B12 levels were normal but the serum
folic acid concentration was reduced in eight of 20 patients. A dose--response study indicated that a similar
cholesterol-lowering effect was obtained with daily doses of 9 and 15 g of Secholex. It is concluded that Secholex is a relatively safe
drug which effectively reduces serum
cholesterol levels in two-thirds of patients with severe
hypercholesterolemia.