Abstract
We compared the long-term effects of pravastatin (CS-514) (CS), probucol (PB) and cholestyramine (CH) on serum lipids and regression of Achilles tendon xanthomas in 66 heterozygous patients with familial hypercholesterolemia (FH).
During the single drug regimen, treatment with CS proved to be the most effective in reducing LDL-cholesterol (LDL-C) (CS;-27±9%, PB; -19±8%, CH; -22±10%). Combined use of two of these drugs produced an additive effect. This effect was especially strong when combining CS and PB (CS+PB; -41±9%, CS+CH; -38±9%, PB+CH; -28±14%). By using the three drugs together, LDL-C was reduced much more than with the other regimen (-48±2%) and, consequently, serum lipid levels were normalized.
Single drug treatment caused substantial xanthoma regression which was approximately equal among the three drugs (CS; -5.8%, PB; -4.0% and CH; -5.2%). Furthermore, the regression was greater with combined treatment (CS+PB; -9.6%, CS+CH; -7.1% and PB+CH; -8.0%). The extent of xanthoma regression was most closely correlated with reduction of LDL-C and duration of treatment (r=0.45, p<0.02). Moreover, in patients treated with PB, there was a significant correlation between maximum reduction of HDL-C and the extent of xanthoma regression (r=0.59, p<0.05).
We concluded that intensive drug treatment using a combination of those three drugs, which have different lipid-lowering mechanisms, is useful in heterozygous FH.
