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Short- and Long-term Results

Emilio Ros, MD; Daniel Zambón, MD; Antonia Bertomeu, MD; Eulalia Cusó, PhD; Carolina Sanllehy, PhD; Elena Casals, MD

Arch Intern Med. 1991;151(2):301-305.

Abstract
The hypolipidemic effect of gemfibrozil in severe hypercholesterolemia is not well established. Fifty patients with primary hypercholesterolemia (including 18 patients with familial hypercholesterolemia) and stable low-density lipoprotein cholesterol levels greater than 3.90 mmol/L (>150 mg/dL) (6.10 1.30 [SD] mmol/L; 236 ±50 mg/dL) while on a hypolipidemic diet were assigned to treatment for 12 weeks with either 9 g/d of filicol, a microporous cholestyramine analogue, or 1.2 g/d of gemfibrozil in a randomized clinical trial. Tolerance was good with both drugs. Filicol and gemfibrozil caused similar decrements of total cholesterol (14% for both), low-density lipoprotein cholesterol (20% and 18%, respectively), and apolipoprotein B (16% and 21%, respectively). Close to 40% of the patients had decreases of greater than 25% in low-density lipoprotein cholesterol levels with both drugs. Gemfibrozil, but not filicol, significantly increased plasma high-density lipoprotein cholesterol (16%) and apolipoprotein A-I (17%) levels and reduced triglyceride levels (35%). No loss of efficacy was observed with either drug in subsets of patients who had a good 12-week response rate and had extended therapy for up to 12 months. This study demonstrates that gemfibrozil may have a beneficial effect on all aspects of the plasma lipid profile in patients with severe hypercholesterolemia, a clinical situation where it can be used with potential advantages over standard doses of anion-exchange resins.

(Arch Intern Med. 1991;151:301-305)

Author Affiliations
From the Lipid Clinic (Gastroenterology Service) (Drs Ros, Zambón, and Bertomeu) and the Department of Biochemistry (Drs Cusó, Sanllehy, and Casals), Hospital Clinic i Provincial, Barcelona (Spain) Medical School.

Footnotes
Accepted for publication July 11, 1990.

Presented in part to the eighth International Symposium on Atherosclerosis, Rome, Italy, October 13, 1988.

Reprint requests to Lipid Clinic, Hospital Clinic i Provincial, Calle Villarroel 170, 08036 Barcelona, Spain (Dr Ros).

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