title: Lovastatin versus bezafibrate: efficacy, tolerability, and effect on urinary mevalonate.
abstract: 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.
authors.affiliation: I. Medizinische Klinik, Universitäts-Krankenhaus Eppendorf, Hamburg, FRG.
authors.forename: F U
authors.initials: FU
authors.lastname: Beil
authors.forename: A
authors.initials: A
authors.lastname: Schrameyer-Wernecke
authors.forename: U
authors.initials: U
authors.lastname: Beisiegel
authors.forename: H
authors.initials: H
authors.lastname: Greten
authors.forename: J D
authors.initials: JD
authors.lastname: Karkas
authors.forename: R
authors.initials: R
authors.lastname: Liou
authors.forename: A W
authors.initials: AW
authors.lastname: Alberts
authors.forename: H G
authors.initials: HG
authors.lastname: Eckardt
authors.forename: A E
authors.initials: AE
authors.lastname: Till
mesh_terms: 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
chemical_list: D008055:Lipids; D008148:Lovastatin; D008798:Mevalonic Acid; D001629:Bezafibrate