Etofibrate therapy and effect of added low-dose cholestyramine in patients with combined hyperlipidaemia

Patients with cardiovascular risk factors often have combined hyperlipidaemia which can be effectively treated with fibrate drugs. Resins can be added when further cholesterol reduction is necessary. In this clinical study, after an initial 4-week placebo prephase, 40 high-risk patients with combined hyperlipidaemia were treated with 2 x 500 mg etofibrate per day for five months to reduce blood lipids according to the intervention guidelines. Low-dose cholestyramine was added when further cholesterol reduction was needed. In 23 patients it was found that total cholesterol and LDL cholesterol could be significantly and sufficiently reduced by 30% (p < 0.05), and by 28.8% (p < 0.05) with etofibrate therapy alone. Additional cholestyramine treatment was necessary in 17 patients, resulting in significant total reductions of 37.6% (p < 0.05) in total cholesterol and 36.7% (p < 0.05) in LDL cholesterol by 4 g cholestyramine per day. Triglyceride reductions (22.8% and 25.0%) and fibrinogen reductions (11.2% and 13.4%) were similar in both treatment groups, showing no influence of the addition of cholestyramine. Tolerance and safety data revealed no negative effects for either treatment. Thus etofibrate, either alone or in combination with low-dose cholestyramine, proved to be an effective and well-tolerated therapeutic regime in combined hyperlipidaemia.