Effectiveness of statin-gemfibrozil combination therapy in patients with mixed hyperlipidemia: experience of a community lipid clinic and safety review from the literature.

Abstract

This retrospective study was carried out to assess the effectiveness of statin-gemfibrozil combination therapy in a community practice lipid clinic and to review safety data from published literature. Forty-six consecutive patients received a statin and gemfibrozil combination for resistant hyperlipidemia to either agent therapy. Fasting total cholesterol (mg/dL), high-density lipoprotein cholesterol (mg/dL), and triglycerides (mg/dL) were measured. Low-density lipoprotein cholesterol (mg/dL) was calculated using the Friedewald formula if triglycerides were <400 mg/dL. Combination therapy reduced total cholesterol, low-density lipoprotein cholesterol, and triglycerides by 11% (p=0.02), 22% (p=0.049), and 39% (p=0.0002), respectively, and raised high-density lipoprotein cholesterol by 5% (p=0.3). A pooled analysis of 838 patients from the literature on statin-gemfibrozil combination therapy revealed an incidence of myositis and severe myopathy of 0.7% and 0.6%, respectively (excluding cerivastatin). We conclude that statin-gemfibrozil combination therapy is effective in significantly reducing total cholesterol, low-density lipoprotein cholesterol, and triglycerides with a trend toward raising high-density lipoprotein cholesterol in patients with hyperlipidemia resistant to either agent alone. Myositis and severe myopathy are infrequent, but not rare side effects which may be statin-specific regarding the incidence of occurrence.

• Authors: Nicholas W Shammas, Matthew J Kapalis, Judi Deckert, Melodee Harris, Eric J Dippel, Ajay Labroo, Dawn McKinney
• Journal: Preventive cardiology (Prev Cardiol) Vol. 6 Issue 4 Pg. 189-94 ( 2003) ISSN: 1520-037X [Print] United States
• PMID: 14605512 (Publication Type: Journal Article, Meta-Analysis)

Chemical References

• Cholesterol, HDL
• Cholesterol, LDL
• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Triglycerides
• Gemfibrozil

Topics

• Aged
• Cholesterol, HDL (blood)
• Cholesterol, LDL (blood)
• Female
• Gemfibrozil (administration & dosage, adverse effects, therapeutic use)
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, adverse effects, therapeutic use)
• Hyperlipidemias (blood, drug therapy)
• Male
• Middle Aged
• Myositis (chemically induced)
• Retrospective Studies
• Rhabdomyolysis (chemically induced)
• Treatment Outcome
• Triglycerides (blood)