The
oral administration of
neomycin or
niacin as single-
drug therapy can significantly lower total and
low-density lipoprotein cholesterol concentrations in patients with
type II hyperlipoproteinemia. However, in the majority of patients treated with one of these drugs as sole
therapy plasma
lipid and
lipoprotein concentrations do not normalize. The effect of combined
neomycin (2 g/day) and
niacin (3 g/day) treatment on the plasma
lipoprotein concentrations was determined in 25 type II hyperlipoproteinemic patients in a double-blind, randomized, placebo-controlled, crossover clinical trial. Treatment with
neomycin was well tolerated by all 25 study patients and significantly reduced total and
low-density lipoprotein cholesterol concentrations by 23% and 29%, respectively (p less than .05). In contrast to the well-tolerated
neomycin regimen, 11 patients (44%) were unable to continue
niacin treatment because of adverse side effects. In the 14 patients treated with both
neomycin and
niacin,
niacin further lowered the concentrations of total and
low-density lipoprotein cholesterol by 18% and 25%, respectively, and increased
high-density lipoprotein cholesterol by 32% (p less than .05) compared with that in the patients receiving
neomycin plus
niacin placebo. Compared with diet-only
therapy, combined treatment with
neomycin plus
niacin reduced the total plasma
cholesterol concentration by 36%,
low-density lipoprotein cholesterol by 45%, and the
low-density lipoprotein/
high-density lipoprotein ratio by 46% and it increased plasma
high-density lipoprotein concentrations by 24% (p less than .001). During the study, 80% of all the study patients and 92% of the patients who complied with the combined regimen normalized their total and
low-density lipoprotein concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)