The clinical and nutritional implications of lipid-lowering drugs that act in the gastrointestinal tract.
OBJECTIVE
A new class of cholesterol-lowering therapy that reduces intestinal sterol absorption has recently been introduced. This increases the number of classes of lipid-lowering agents that directly affect gastrointestinal function and raises questions concerning the overall effect of these agents on absorption and nutritional status.


RESULTS
A recent assessment notes a paucity of information concerning the factors that affect the bioavailability and intestinal absorption of lipophilic nutrients. By contrast, the specificity of the mechanisms of action of new drugs acting on the gastrointestinal tract may circumvent some of the detrimental effects on nutrient and drug bioavailability that have been noted with older forms of treatment.


CONCLUSIONS
The clinical imperative for aggressive control of lipid and metabolic risk factors makes widespread use, alone or in combination, of lipid-lowering agents that affect the gastrointestinal tract seem increasingly likely. Whilst the opportunity for therapeutic synergy is attractive, care will be required to avoid interference with intestinal absorptive function.
Sullivan
David R
DR
Department of Clinical Biochemistry, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales 2050, Australia. david.sullivan@email.cs.nsw.gov.au
D000818:Animals; D001647:Bile Acids and Salts / Q000378:metabolism; D002784:Cholesterol / Q000378:metabolism; D004063:Digestion / Q000187:drug effects; D041981:Gastrointestinal Tract / Q000187:drug effects* / Q000378:metabolism; D006801:Humans; D000960:Hypolipidemic Agents / Q000494:pharmacology*
D001647:Bile Acids and Salts; D000960:Hypolipidemic Agents; D002784:Cholesterol