Fenofibrate and cholestyramine in type II hyperlipoproteinaemia

The effect of fenofibrate (300-600 mg daily) was compared with cholestyramine (12 g daily) in 13 patients with primary type II hyperlipoproteinaemia. Seven of the patients had monogenic familial hypercholesterolaemia. Both fenofibrate (21.0%) and cholestyramine (18.5%) decreased serum cholesterol level. Fenofibrate (22.7%) and cholestyramine (19.6%) had equally decreasing effects on LDL-cholesterol, but fenofibrate increased HDL-cholesterol (10.4%), although not significantly, whereas cholestyramine decreased the HDL-cholesterol (11.9%). Therefore the ratio of HDL-cholesterol to total cholesterol was higher after fenofibrate (0.17) than after cholestyramine (0.13). Serum triglyceride concentration decreased by 57.1 per cent during six months' treatment with fenofibrate, but returned to a higher level during 3 months' cholestyramine treatment. When the dose of fenofibrate was increased from 300 mg to 600 mg daily, serum cholesterol, LDL-cholesterol, and triglyceride values decreased, and HDL-cholesterol and the ratio of HDL-cholesterol to total cholesterol increased, but only in patients with non-familial hypercholesterolaemia. Fenofibrate is in addition to cholestyramine an useful hypolipidaemic drug in type II hyperlipoproteinaemia.