[Effects of low-dose cholestyramine in long-term therapy of hypercholesterolemia]

Sixty-nine patients (mean age 49 +/- 13 years), affected by primary hypercholesterolemia (65 type IIa and 4 type IIb), were treated for 2 years with 12 gr/day cholestyramine subdivided in two doses. Total serum cholesterol decreased from 353 (sd 66) mg/dl to 291 (sd 62) mg/dl (p less than 0.001) at the third month active treatment remaining thereafter constant. Overall, LDL-cholesterol reduced by 30% in cases with a familial form of the metabolic disorder, by 27% and 30% in those with polygenic or indefinite hypercholesterolemia, respectively. HDL-cholesterol remained unchanged during the study whereas serum triglycerides tended toward an increase. The frequency of reported side effects ranged between 11% and 23% of cases. Mostly they were constipation and abdominal discomfort which, however, did not cause a definitive discontinuation of the resin. The favourable side effect profile and the efficacy confirmed that low-dose cholestyramine represents the first choice drug for hypercholesterolemia.