The Effect of Cholestyramine in Hyperlipidemic Patients under Long-Term Therapy

Abstract

Long-term therapy with cholestyramine, a strong basic anion exchange resin, involving 168 cases of type II hyperlipidemic patients resulted in the following observations:
1) The lowering of the serum total cholesterol (TC) level was seen in the second week of the cholestyramine therapy and the statistically significant decrease lasted for the entire 52-week administration period thereafter. The mean reduction rate of TC during the therapy was 14.6% overall.
2) No difference was noted in TC lowering effect of cholestyramine between the group at daily dosage of 8g (109 cases) and the group at daily dosage of 12g (59 cases). Thus the daily dosage of 8g taken twice a day was confirmed to be more beneficial considering the facile administration schedule.
3) No difference in drug efficacy was observed between the 91 cases of type IIa and the 77 cases of type IIb hyperlipidemic patients, and larger rate of decrease was obtained in the group with higher TC levels at pretherapy. The drug was also comfirmed to be effective with familial hypercholesterolemia.
4) During the therapy, serum triglyceride and HDL-cholesterol levels tended to increase, while β-lipoprotein and phospholipid levels slightly decreased.
5) The most frequent side effects were gastrointestinal symptoms such as constipation and abdominal distention, and in most cases continuation of the therapy was possible. In a few cases, increases of serum GOT and GPT levels manifested, but most of them were of minor nature.
In conclusion, cholestyramine is considered to be a safe and highly beneficial drug even against serious cases of type II hyperlipidemic patients including familial hypercholesterolemic patients who have been considered difficult to cure.