Comparison of six pharmacologic regimens for hypercholesterolemia

Six sequential clinical trials were conducted over 5 years to evaluate the safety and efficacy of different treatment regimens for hypercholesterolemia. Of all the study participants, 11 patients were evaluated in all 6 clinical trials using the following regimens: neomycin, neomycin/niacin, cholestyramine, cholestyramine/neomycin, lovastatin and lovastatin/neomycin. All 6 regimens significantly (p less than 0.05) reduced both total and low-density lipoprotein cholesterol concentrations by 25 to 42% from baseline levels. Only neomycin/niacin, cholestyramine and lovastatin significantly increased the high-density lipoprotein (HDL) cholesterol concentration, reducing the total cholesterol/high-density lipoprotein cholesterol ratio to less than 4.7. Thus, all 6 tested regimens were effective in modifying the plasma lipoprotein concentrations in type II hyperlipoproteinemia, but neomycin/niacin, cholestyramine and lovastatin had the most favorable impact. Only lovastatin treatment was free of adverse effects.