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Colesevelam HCl reduces LDL particle number and increases LDL size in hypercholesterolemia

Robert S Rosenson1

  • 1Preventive Cardiology Center, Department of Medicine, Division of Cardiology, Northwestern University, The Feinberg School of Medicine, Galter Pavilion, Suite 11-120, 201 East Huron Street, Chicago, IL 60611, USA. r-rosenson@norhwestern.edu

Atherosclerosis
|July 13, 2005
PubMed

Insights

Colesevelam HCl effectively lowers LDL particle number and increases LDL particle size in patients with moderate hypercholesterolemia. This bile acid sequestrant offers a new therapeutic option for managing cardiovascular risk factors.

Area of Science:

  • Cardiology
  • Pharmacology
  • Metabolic Disorders

Background:

  • LDL-cholesterol (LDL-C) is a primary target for lipid-lowering therapies.
  • Elevated LDL particle numbers are a stronger indicator of cardiovascular risk than LDL-C levels.
  • Colesevelam HCl, a bile acid sequestrant, reduces LDL-C but its impact on LDL particle number and size was unknown.

Purpose of the Study:

  • To investigate the effects of Colesevelam HCl on LDL particle number and particle size.
  • To determine if baseline triglyceride levels or LDL size influence the changes in LDL particle number.

Main Methods:

  • A multi-center, double-blind, placebo-controlled study.
  • 149 patients with moderate hypercholesterolemia were randomized to receive Colesevelam HCl (1.5-3.75 g/d) or placebo for 6 weeks.
  • LDL particle number and size were measured using NMR spectroscopy.

Main Results:

  • Colesevelam HCl significantly reduced LDL particle number at dosages of 3.0 g/d (6.8% reduction) and 3.75 g/d (13.7% reduction).
  • No influence of baseline triglycerides or LDL size on changes in LDL particle number was observed.
  • A significant increase in mean LDL particle size was noted with 3.75 g/d of Colesevelam HCl (1.1% increase).

Conclusions:

  • Colesevelam HCl at the recommended dose of 3.75 g/d lowers LDL particle number in patients with moderate hypercholesterolemia.
  • Treatment with Colesevelam HCl also increases mean LDL particle size.
  • These findings suggest Colesevelam HCl may offer a dual benefit in managing cardiovascular risk by targeting LDL particle number and size.
Abstract

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