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[Treatment of severe primary hypercholesterolemia with lovastatin (Mevacor). A new therapeutic principle]
1Københavns Amts Sygehus i Glostrup, lipidambulatoriet, medicinsk afdeling C.
Insights
Lovastatin significantly reduced serum cholesterol and LDL-cholesterol in patients with severe hypercholesterolemia. This cholesterol-lowering drug also increased HDL-cholesterol, with minimal side effects observed.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Severe hypercholesterolemia poses a significant risk for ischemic cardiac disease.
- Familial hypercholesterolemia is a common genetic form requiring effective treatment.
- Dietary interventions alone may not be sufficient for managing severe cholesterol levels.
Purpose of the Study:
- To evaluate the efficacy of lovastatin in reducing serum cholesterol and its subfractions.
- To assess the impact of lovastatin on lipid profiles in patients with severe hypercholesterolemia.
- To determine the safety and tolerability of lovastatin treatment.
Main Methods:
- An open clinical trial involving 59 outpatients with severe hypercholesterolemia.
- Initial dietary regulation followed by six months of lovastatin treatment (average dose 59 mg/24 hours).
- Monitoring of serum cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides.
Main Results:
- A 45% decrease in total serum cholesterol and a 44% decrease in LDL-cholesterol were observed.
- High-density lipoprotein (HDL)-cholesterol increased by over 21%, and triglycerides fell by 20%.
- The total cholesterol/HDL-cholesterol ratio improved significantly, and side effects were minimal and transient.
Conclusions:
- Lovastatin demonstrates a pronounced, dosage-related effect in lowering serum cholesterol and LDL-cholesterol.
- The drug effectively improves the overall lipid profile, including increasing HDL-cholesterol.
- Lovastatin is well-tolerated in patients with severe hypercholesterolemia, with a favorable safety profile.
Abstract:
An open clinical trial comprising 59 outpatients with severe hypercholesterolemia (including 35 patients with familial hypercholesterolaemia) and considerable predisposition to ischaemic cardiac disease revealed a dosage-related pronounced effect of lovastatin on serum cholesterol and subfractions of this. After dietary regulation for a period of four months, a decrease in serum cholesterol of 11.7% was observed and after further treatment for six months with lovastatin with an average dose of 59 mg per 24 hours, the serum cholesterol decreased with a total of 45% of original value. Low density lipoprotein (LDL)-cholesterol decreased 44% and high density lipoprotein (HDL)-cholesterol increased by over 21%. Serum triglyceride fell by 20%. The serum-cholesterol/HDL-cholesterol ratio was reduced from 8.8 to 4.9. Only slight and transient subjective side-effects were observed and none of the patients dropped out of the trial for this reason. One patient with recognized ischaemic heart disease died from myocardial infarction. A tendency towards increasing liver parameters and creatin kinase was observed in the group as a whole but was not significant.