title: Lovastatin (mevinolin) in the treatment of heterozygous familial hypercholesterolemia. A multicenter study.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of lovastatin under controlled conditions in heterozygous familial hypercholesterolemia.
  
  
  METHODS
  Randomized, double-blind, placebo-controlled, multicenter trial.
  
  
  METHODS
  Five lipid clinics with a central laboratory and coordinating center.
  
  
  METHODS
  101 adult patients with heterozygous familial hypercholesterolemia.
  
  
  METHODS
  Patients were on a lipid-lowering diet throughout the study. After a 4-week placebo baseline period, patients were randomized to five equal treatment groups. Each group received a different sequence of placebo or lovastatin 5 to 40 mg twice daily or 20 to 40 mg once daily in the evening, during three consecutive 6-week periods.
  
  
  RESULTS
  The mean reductions in total plasma cholesterol and low-density lipoprotein cholesterol across the dosage ranges were 14% to 34% and 17% to 39%, respectively (p compared with zero and placebo less than 0.01). High-density lipoprotein cholesterol and apolipoproteins AI and AII rose slightly. Apolipoprotein B fell substantially at the higher dosage levels (-23% at 40 mg twice daily, p less than 0.01), indicating a reduction in the concentration of circulating low-density lipoprotein particles. Maximum response was achieved in 4 to 6 weeks. Twice-daily dosing was slightly more efficient than once-daily dosing. Of those patients receiving 40 mg twice a day, 89% had a fall in low-density lipoprotein cholesterol of at least 20%, and 61% had a fall of at least 40%. Adverse effects attributable to lovastatin were minimal, and no patient was withdrawn from the study.
  
  
  CONCLUSIONS
  Lovastatin was well tolerated and effective in the treatment of familial hypercholesterolemia.
authors: Cardiovascular Research Institute, School of Medicine, University of California, San Francisco.
authors: R J
authors: RJ
authors: Havel
authors: D B
authors: DB
authors: Hunninghake
authors: D R
authors: DR
authors: Illingworth
authors: R S
authors: RS
authors: Lees
authors: E A
authors: EA
authors: Stein
authors: J A
authors: JA
authors: Tobert
authors: S R
authors: SR
authors: Bacon
authors: J A
authors: JA
authors: Bolognese
authors: P H
authors: PH
authors: Frost
authors: G E
authors: GE
authors: Lamkin
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D001055:Apolipoproteins B / Q000097:blood; D002386:Cataract / Q000139:chemically induced; D002784:Cholesterol / Q000097:blood; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004341:Drug Evaluation; D005260:Female; D006579:Heterozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000188:drug therapy* / Q000235:genetics; D008148:Lovastatin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D011897:Random Allocation
chemical_list: D001055:Apolipoproteins B; D002784:Cholesterol; D008148:Lovastatin; D000410:Alanine Transaminase