Effects of atorvastatin on serum lipids of patients with familial hypercholesterolaemia.
OBJECTIVE
The effects of atorvastatin, a new synthetic HMG-CoA reductase inhibitor, were investigated in patients with familial hypercholesterolaemia (FH), with high LDLc levels whilst on standard treatment.


METHODS
Open treatment with 40 mg atorvastatin daily for 6 weeks, followed by another 6 weeks with 80 mg atorvastatin.


METHODS
Outpatient lipid clinic of a tertiary referral centre.


METHODS
FH was diagnosed when the untreated LDLc concentration was higher than 6 mmol L-1, tendon xanthomas were present at the participant or a first degree relative, and the family history for hypercholesterolaemia was positive. The FH patients were selected for an LDLc above 5.0 mmol L-1 whilst on standard therapy for at least 3 months. Standard therapy consisted of a diet and 40 mg simvastatin, either alone (n = 17), or in combination with 8-12 g colestyramin (n = 12), or 1800 mg nicotinic acid (n = 12).


METHODS
Effects on LDLc concentration.


RESULTS
LDLc concentration significantly decreased during treatment with 80 mg atorvastatin as compared to LDLc levels on 40 mg simvastatin alone or in combination with 8-12 g colestyramin, by 24 +/- 14% (P < 0.01) and 19 +/- 22% (P < 0.01), respectively. LDLc concentration was comparable during treatment with 80 mg atorvastatin or 40 mg simvastatin in combination with 1800 mg nicotinic acid. Atorvastatin was tolerated well, no side-effects were observed.


CONCLUSIONS
Atorvastatin is a valuable addition to the treatment possibilities of patients with serious hypercholesterolaemia, like FH.
Hoogerbrugge
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Department of Internal Medicine III, University Hospital Dijkzigt, Rotterdam, The Netherlands. hoogerbrugge@inw3.azrnl
D000328:Adult; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001053:Apolipoproteins / Q000097:blood; D000069059:Atorvastatin; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D002792:Cholestyramine Resin / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use*; D019821:Simvastatin / Q000627:therapeutic use; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood
D000924:Anticholesteremic Agents; D001053:Apolipoproteins; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D011758:Pyrroles; D014280:Triglycerides; D002792:Cholestyramine Resin; D009525:Niacin; D000069059:Atorvastatin; D019821:Simvastatin