Lovastatin versus bezafibrate: efficacy, tolerability, and effect on urinary mevalonate.
Lovastatin and benzafibrate have proved effective in lowering low-density-lipoprotein (LDL) cholesterol and elevating high-density-lipoprotein (HDL) cholesterol. We compared their tolerability, safety, and effects on lipoproteins and urinary mevalonate excretion in a short-term study. Forty patients with primary hypercholesterolemia were enrolled in a single-blind randomized study with a diet/placebo period of 8 weeks and a treatment period of 12 weeks. Twenty patients received lovastatin (final average dose 70.5 mg/day), and 20 patients received bezafibrate 400 mg/day. LDL cholesterol was lowered by 35% (from 323 to 208 mg/dl) with lovastatin and by 8% (from 289 to 264 mg/dl) with benzafibrate. HDL cholesterol increased by 21 and 20% with lovastatin and benzafibrate, respectively. Twenty-four-hour urinary mevalonic acid output decreased by 37% during treatment with lovastatin and by 2% during treatment with bezafibrate. Thus, the lowering of cholesterol by lovastatin, but not by bezafibrate, can be attributed to inhibition of HMG CoA (3-hydroxy-3-methylglutaryl coenzyme A) reductase. Both lovastatin and bezafibrate are well tolerated.
Beil
F U
FU
I. Medizinische Klinik, Universitäts-Krankenhaus Eppendorf, Hamburg, FRG.
Schrameyer-Wernecke
A
A
Beisiegel
U
U
Greten
H
H
Karkas
J D
JD
Liou
R
R
Alberts
A W
AW
Eckardt
H G
HG
Till
A E
AE
D000328:Adult; D000368:Aged; D001629:Bezafibrate / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy* / Q000652:urine; D008055:Lipids / Q000097:blood; D008148:Lovastatin / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008798:Mevalonic Acid / Q000652:urine*; D008875:Middle Aged; D016037:Single-Blind Method
D008055:Lipids; D008148:Lovastatin; D008798:Mevalonic Acid; D001629:Bezafibrate