The effect of consecutive treatment with 900 mg of gemfibrozil once a day was evaluated in patients with primary hypercholesterolemia whose global lipid profile had been satisfactorily controlled with 20 mg of simvastatin once a day. Twenty outpatients with type IIa or IIb primary hypercholesterolemia participated in the two-phase study. During the open phase, patients received simvastatin for 8 weeks; thereafter, they were randomly assigned in double-blind manner to placebo or gemfibrozil for 12 weeks. Simvastatin induced highly significant decreases in total (TC) (20.5%) and low-density lipoprotein (LDL) (25.6%) cholesterol. Triglycerides decreased by 11.2%, while high-density lipoprotein (HDL) remained unchanged. In the second phase, placebo patients exhibited severe impairment of the lipid profile 4 weeks after suspension of simvastatin. LDL increased by 52% and HDL decreased by 23%. Ratios of TC:HDL and LDL:HDL increased dramatically. In succeeding weeks, lipid parameters approximated baseline values. Compared with values at the end of simvastatin treatment, HDL increased by 12.7% and triglycerides decreased by 25% in patients treated with gemfibrozil. Statistically nonsignificant trends to increases in TC and LDL were noted; TC:HDL and LDL:HDL ratios remained unchanged. The 8-week simvastatin treatment was well tolerated, and consecutive gemfibrozil treatment for an additional 12 weeks was safe and effective. Therapeutic effects on the lipid profile achieved by short-term simvastatin treatment were sustained by subsequent gemfibrozil treatment.
|Number of pages||8|
|Journal||Advances in Therapy|
|Publication status||Published - 1993|
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