Abstract
Familial hypercholesterolemia and familial combined hyperlipidemia are the most threatening disorders of lipoprotein metabolism regarding premature atherosclerotic complications. Dietary and drug monotherapy often are not sufficient to control these disorders. Especially in patients with symptomatic coronary artery disease LDL-cholesterol should be lowered at least to 135 mg/dl (or even 100 mg/dl ?). This is often achieved only with combined treatment. As shown in figure 1 there are multiple options to combine lipid-regulating drugs with different sites of actions to interfere rather specifically according to the underlying defect of lipoprotein metabolism.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
Literatur
Packard, C.J., Stewart J.M., Morgan H.G., Lorimer A.R. and Shepherd J. (1980) ‘Combined drug therapy for familial hypercholesterolemia’, Artery 7:281–289
Angelin B., Eriksson M. and Einarsson K. (1986) ‘Combined treatment with cholestyramine and nicotinic acid in heterozygous familial hypercholestrolemia: effects on biliary lipid composition’, Europ — Clin Invest 16:391–396
Series, J.J., Gaw A., Kilday C, Bedford D.K., Lorimer A.R., Packard C.J. and Shepherd J. (1990) ‘Acipimox in combination with low dose cholestyramine for the treatment of type II hyperlipidaemia’, Br — din Pharmac 30:49–54
Gylling H., Vanhanen H. and Miettinen T.A. (1989) ‘Effects of acipimox and cholestyramine on serum lipoproteins, non-cholesterol sterols and cholesterol absorption and elimination’, Eur — Clin Pharmacol 37:111–115
Kane, J.P., Malloy M.J., Tun P., Phillips N.R., Freedman D.D., Williams M.L, Rowe J.S. and Havel R.J. (1981) ‘Normalization of low-density-lipoprotein levels in heterozygous familial hyperchoelsterolemia with — combined drug regimen’, New Engl — Med 304:251–258
Illingworth, D.R., Rapp J.H., Phillipson B.E. and Connor W.E. (1981) ‘Colestipol plus nicotinic acid in treatment of heterozygous familial hypercholesterolemia’, Lancet 1:296–298
Kuo, P.T., Kostis J.B., Moreyra A.E. and Hayes J.A. (1981) ‘Familial type II hyperlipoproteinemia with coronary heart disease’, Chest 79:286–291
Blankenhorn, D.H., Nessim S.A., Johnson R.L, Sanmarco M.E., Azen S.P. and Cashin-Hemphill — (1987) ‘Beneficial effects of combined Colestipol-Niacin therapy on coronary atherosclerosis and coronary venous bypass grafts’, JAMA 257:3233–3240
Cashin-Hemphill, L, Mack W.J., Pogoda J.M., Sanmarco M.E., Azen S.P. and Blankenhorn D.H. (1990) ‘Beneficial effects of Colestipol-Niacin on coronary atherosclerosis’, JAMA 264:3013–3017
Pasquali R., Biso P., Parenti M. and Melchionda N. (1981) ‘Combined effects of probucol and cholestyramine in familial type II hyperlipoproteinaemia’, Lancet 1:1368
Kane, J.P., Malloy M.J., Ports T.A., Phillips N.R., Diehl J.C. and Havel R.J. (1990) ‘Regression of coronary atherosclerosis during treatment of familial hypercholesterolemia with combined drug regimens’, JAMA 264:3007–3012
Brown G., Albers J.J., Fisher L.D., Schaefer S.M., Lin J.T., Kaplan C, Zhao X.Q., Bisson B.D., Fitzpatrick V.F. and Dodge H.T. (1990) ‘Regression of coronary artery disease as — result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B’, New Engl — Med 323:1289–1298
Malloy, M.J., Kane J.P., Kunitake ST. and Tun P. (1987) ‘Complementarity of Colestipol, Niacin, and Lovastatin in treatment of severe familial hypercholesterolemia’, Ann Intern Med 107:616–623
Goodman, D.S., Noble R.P. and Dell R.B. (1973) The effects of colestipol resin and of colestipol plus clofibrate on the turnover of plasma cholesterol in man’, — Clin Invest 52:2646–2655
Rose, H.G., Haft G.K. and Juliano J. (1976) ‘Clofibrate-induced low density lipoprotein elevation therapeutic implications and treatment by colestipol resin’, Atherosclerosis 23:413–427
Fellin R., Baggio G., Briani G., Baiocchi M.R., Manzato E., Baldo G. and Crepaldi G. (1978) ‘Long-term trial with colestipol plus clofibrate in familial hypercholesterolemia’, Atherosclerosis 29:241–249
Hunninghake, D.B., Bell C. and Olson — (1981) ‘Effects of Colestipol and Clofibrate, singly and in combination, on plasma lipid and lipoproteins in type lib hyperlipoproteinemia’, Metabolism 30:610–615
Hoogwerf, B.J., Peters J.R., Frantz I.D. and Hunninghake D.B. (1985) ‘Effect of clofibrate and colestipol singly and in combination on plasma lipids and lipoproteins in type III hyperlipoproteinemia’, Metabolism 34:978–981
Curtis, L.D., Dickson A.C., Ling K.L.E. and Betteridge J. (1988) ‘Combination treatment with cholestyramine and bezafibrate for heterozygous familial hypercholesterolemia’, Brit Med — 297:173–175
Series, J.J., Caslake M.J., Kilday C, Cruickshank A., Demant T, Lorimer A.R., Packard C.J. and Shepherd J. (1989) ‘Effect of combined therapy with bezafibrate and cholestyramine on low-density lipoprotein metabolism in type Ha hypercholesterolemia’, Metabolism 38:153–158
Fischer S., Hanefeld M., Lang P.D., Fucker K., Bergmann S., Gehrisch S., Leonhardt W. and JaroB W. (1990) ‘Efficacy of — combined bezafibrate retard-colestyramine treatment in patients with hypercholesterolemia’, Arzneim.-Forsch./Drug Res. 40:469–472
Jones, A.F., Hughes E.A. and Cramb R. (1988) ‘Gemfibrozil plus cholestyramine in familial hypercholesterolemia’, Lancet 1:776
East, C, Bilheimer D.W. and Grundy S.M. (1988) ‘Combination drug therapy for familial combined hyperlipidemia’, Ann Intern Med 109:25–32
Dujovne, C.A., Krehbiel P., DeCoursey S., Jackson B., Chemoff S.B., Pittermann A. and Garty M. (1984) ‘Probucol with colestipol in the treatment of hyperchoelsterolemia’, Ann Intern Med 100:477–482
Weisweiler, P. and Schwandt P. (1986) ‘Colestipol plus fenofibrate versus synvinolin in familial hypercholesterolemia’, Lancet 11:1212–1213
Malmendier, C.L, Delcrolx C. and Lontie J.F. (1987) The effect of combined fenofibrate and cholestyramine therapy on low-density lipoprotein kinetics in familial hypercholesterolemia patients’, Clin Chim Acta 162:221–227
Dujovne, C.A., Chernoff S.B., Krehbiel P., Jackson B., DeCoursey S. and Taylor H. (1984) ‘Low-dose colestipol plus probucol for hypercholesterolemia’, Am — Cardiol 53:1514–1518
Sommariva D., Bonfiglioli D., Tirrito M., Pogliaghi I., Branchi A. and Cabrini E. (1986) ‘Probucol and cholestyramine combination in the treatment of severe hypercholesterolemia’, Int — Clin Pharm Ther Toxicol 24:505–510
Kuo, P.T., Wilson A.C., Kostis J.B. and Moreyra A.E. (1986) ‘Effects of combined probucol-colestipol treatment for familial hypercholestrolemia and coronary artery disease’, Am — Cardiol 57:43H–48H
Cashin-Hemphill, L, Spencer C.A., Nicoloff J.T., Blankenhorn D.H., Nessim S.A., Chin H.P. and Lee N.A. (1987) ‘Alterations in serum thyroid hormonal indices with colestipol-niacin therapy’, Ann Intern Med 107:324–329
Mabuchi H., Sakao T., Sakai Y., Yoshimura A., Watanabe A., Wakasugi T., Koizumi J. and Takeda R. (1983) ‘Reduction of serum cholesterol in heterozygous patients with familial hypercholesterolemia’, New Engl — Med 308:609–613
Illingworth, D.R. (1984) ‘Mevinolin plus colestipol in therapy for severe heterozygous familial hypercholesterolemia’, Ann Intern Med 101:598–604
Grundy, S.M., Vega G.L and Bilheimer D.W. (1985) ‘Influence of combined therapy with mevinolin and interruption of bile-acid reabsorption on low density lipoproteins in heterozygous familial hypercholesterolemia’, Ann Intern Med 103:339–343
Vega, G.L. and Grundy S.M. (1987) Treatment of primary moderate hypercholesterolemia with lovastatin (Mevinolin) and colestipol)’, JAMA 257:33–38
Leren, T.P., Hjermann I., Berg K., Leren P., Foss O.P. and Viksmoen — (1988) ‘Effects of lovastatin alone and in combination with cholestyramine on serum lipids and apolipoproteins in heterozygotes for familial hypercholesterolemia’, Atherosclerosis 73:135–141
Witztum, J.L, Simmons D., Steinberg D., Beltz W.F., Weinreb R., Young S.G., Lester P., Kelly N. and Juliano J. (1989) ‘Intensive combination drug therapy of familial hyperchoelsterolemia with lovastatin, probucol, and colestipol hydrochloride’, Circulation 79:16–28
Jacob, B.G., Mohrle W., Richter W.O., Schwandt P. (1992) ‘Short-and long-term effects of lovastatin and pravastatin alone and in combination with cholestyramine on serum lipids, lipoproteins and apolipoproteins in primary hypercholesterolemia’, Eur — Clin Pharmacol 42:353–358
Pan, H.Y., DeVault A.R., Swites B.J., Whigan D., Ivashkjv E., Willard D.A. and Brescia D. (1990) ‘Pharmacokinetics and pharmacodynamics of pravastatin alone and with cholestyramine in hypercholesterolemia’, Clin Pharmacol Ther 48:201–207
Garg, A. and Grundy S.M. (1989) ‘Gemfibrozil alone and in combination with lovastatin for treatment of hypertriglyceridemia in NIDDM’, Diabetes 38:364–372
Ytre-Arne, K. and Nordoy A. (1989) ‘Simvastatin and cholestyramine in the long-term treatment of hypercholesterolemia’, — Int Med 226:285–290
Illingworth, D.R. and Bacon S. (1989) ‘Influence of lovatatin plus gemfibrozil on plasma lipids and lipoproteins in patients with heterozygous familial hypercholesterolemia’, Circulation 79:590–596
Emmerich J., Aubert I., Bauduceau B., Dachet D., Chanu B., Erlich D., Gautier D., Jacotot B. and Rouffy J. (1990) ‘Efficacy and safety of simvastatin (alone or in association with cholestyramine). — 1-year study in 66 patients with type II hyperlipoproteinaemia’, Europ Heart — 11:149–155
Geisel J., Oette K. and Burrichter H. (1990) ‘HMG-CoA-Reduktase-lnhibitoren bei familiärer Hypercholesterinämie’, Fortschr Med 108:69–72
Molgaard J., Lundh B.L, von Schenck H. and Olsson A.G. (1991) ‘Long-term efficacy and safety of simvastatin alone and in combination therapy in treatment of hypercholesterolemia’, Atherosclerosis 91:S21–S28
Glueck, C.J., Speirs J. and Tracy T. (1990) ‘Safety and efficacy of combined gemfibrozil-lovastatin therapy for primary dyslipoproteinemias’, — Lab Clin Med 115:603–609
Illingworth, D.R. and O’Malley J.P. (1990) The hypolipidemic effects of lovastatin and clofibrate alone and in combination in patients with type III hyperlipoproteinemia’, Metabolism 39:403–409
Lintott, C.J., Scott R.S., Nye E.R., Robertson M.L and Sutherland W.H.F. (1991) The hypolipidaemic effects of pravastatin (CS-514) alone and in combination with bezafibrate or acipimox in patients with primary hypercholesterolemia’, Diab Nutr Metab 4:117–122
Pierce, L.R., Wysowski D.K. and Gross T.P. (1990) ‘Myopathy and rhabdomyolysis associated with lovastatin-gemfibrozil combination therapy’, JAMA 264:71–75
Illingworth, D.R. and Bacon S. (1989) Treatment of heterozygous familial hypercholestrolemia with lipid-lowering drugs’, Arteriosclerosis (Suppl I) 9:1-121-134
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1993 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Schwandt, P. (1993). Combined Drug Treatment of Severe Hypercholesterolemia. In: Catapano, A.L., Gotto, A.M., Smith, L.C., Paoletti, R. (eds) Drugs Affecting Lipid Metabolism. Medical Science Symposia Series, vol 2. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-1703-6_35
Download citation
DOI: https://doi.org/10.1007/978-94-011-1703-6_35
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-010-4746-3
Online ISBN: 978-94-011-1703-6
eBook Packages: Springer Book Archive