Long term efficacy and safety of atorvastatin in the treatment of severe type III and combined dyslipidaemia

• Published in: Heart (British Cardiac Society) Vol. 88; no. 3; pp. 234 - 238
• Main Authors: van Dam, M, Zwart, M, de Beer, F, Smelt, A H M, Prins, M H, Trip, M D, Havekes, L M, Lansberg, P J, Kastelein, J J P
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Cardiovascular Society 01-09-2002; BMJ; BMJ Publishing Group Ltd; BMJ Publishing Group LTD; Copyright 2002 by Heart
• Subjects: Adult; Aged; Anticholesteremic agents; apo E; apolipoprotein E; Apolipoproteins B - blood; Apolipoproteins B - genetics; Atorvastatin; Biological and medical sciences; Cardiovascular disease; Cardiovascular Medicine; cholesterol; Cholesterol - blood; Drug therapy; Evaluation; familial dysbetalipoproteinaemia; Female; General and cellular metabolism. Vitamins; HDL; Heptanoic Acids - adverse effects; Heptanoic Acids - therapeutic use; high density lipoprotein; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipidemias - blood; Hyperlipidemias - drug therapy; Hyperlipoproteinemia Type III - blood; Hyperlipoproteinemia Type III - drug therapy; IDL; intermediate density lipoprotein (VLDL remnants); LDL; Lipid metabolism disorders; Lipids; Low density lipoprotein; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pyrroles - adverse effects; Pyrroles - therapeutic use; Rodents; severe combined dyslipidaemia; Statins; Studies; Treatment Outcome; triglyceride; Triglycerides - blood; very low density lipoprotein; VLDL; Hypolipemia; Human; Nervous system diseases; Abetalipoproteinemia; Enzyme; Toxicity; Treatment efficiency; Enzyme inhibitor; Clinical form; Metabolic diseases; Lipids; Statin derivative; Enzymopathy; Long term; Cerebral disorder; Genetic disease; Chemotherapy; Treatment; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; Severity score; Oxidoreductases; Dyslipemia; Antilipemic agent
• ISSN: 1355-6037; 1468-201X
• DOI: 10.1136/heart.88.3.234

Background: Fibric acid derivatives and HMG-CoA reductase inhibitors are effective in combination for treating patients with familial dysbetalipoproteinaemia and severe combined dyslipidaemia, but combination therapy affects compliance and increases the risk of side effects. Aim: To evaluate the efficacy and safety of monotherapy with atorvastatin, an HMG-CoA reductase inhibitor with superior efficacy in lowering low density lipoprotein cholesterol and triglyceride concentrations, in patients with dysbetalipoproteinaemia and severe combined dyslipidaemia. Methods: Atorvastatin was tested as single drug treatment in 36 patients with familial dysbetalipoproteinaemia and 23 patients with severe combined dyslipidaemia. Results: After 40 weeks of 40 mg atorvastatin treatment decreases in total cholesterol, triglycerides, and apolipoprotein B of 40%, 43%, and 41%, respectively, were observed in the combined dyslipidaemia group, and of 46%, 40%, and 43% in the dysbetalipoproteinaemic patients. Target concentrations of total cholesterol (< 5 mmol/l) were reached by 63% of the patients, and target concentrations of triglycerides (< 3.0 mmol/l) by 66%. Treatment with atorvastatin was well tolerated and no serious side effects were reported. Conclusions: Atorvastatin is very effective as monotherapy in the treatment of familial dysbetalipoproteinaemia and severe combined dyslipidaemia.