Short-term effects of statin therapy in patients with hyperlipoproteinemia after liver transplantation: results of a randomized cross-over trial

• Published in: Journal of hepatology Vol. 35; no. 1; pp. 86 - 91
• Main Authors: Zachoval, R, Gerbes, A.L, Schwandt, P, Parhofer, Klaus G
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier B.V 01-07-2001; Elsevier
• Subjects: Aged; Atherosclerosis; Biological and medical sciences; Cerivastatin; Cholesterol - blood; Cholesterol, LDL - blood; Cross-Over Studies; Cyclosporine - therapeutic use; Digestive system; Dose-Response Relationship, Drug; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hyperlipoproteinemias - blood; Hyperlipoproteinemias - drug therapy; Hyperlipoproteinemias - etiology; Immunosuppression; Immunosuppressive Agents - therapeutic use; Liver Transplantation - adverse effects; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Pravastatin; Pravastatin - administration & dosage; Pravastatin - therapeutic use; Prospective Studies; Pyridines - administration & dosage; Pyridines - therapeutic use; Time Factors; Immunosuppression; Pravastatin; Cerivastatin; Atherosclerosis; Human; Liver; Metabolic diseases; Lipids; Transplantation; Hyperlipoproteinemia; Homotransplantation; Crossover study; Biological activity; Chemotherapy; Randomization; Surgery; Complication; Dyslipemia; Antilipemic agent
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/S0168-8278(01)00044-7

Background/Aims
: Hyperlipoproteinemia is frequent following liver transplantation and may lead to atherosclerosis. Lipid-lowering agents may be useful, but could interfere with the function of the transplanted organ and with immunosuppression. We therefore evaluated in a prospective, randomized, open-labeled cross-over trial the effect of two frequently used 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (pravastatin 10 mg d
−1 and cerivastatin 0.1 mg d
−1) in hyperlipoproteinemic patients after liver transplantation.
Methods
: Sixteen patients (6.3±2.0 years post-transplantation, cyclosporine
n
=11, tacrolimus
n
=5) with hyperlipoproteinemia (cholesterol 246±42, triglycerides 191±87, low-density lipoprotein (LDL)-cholesterol 161±35, high-density lipoprotein (HDL)-cholesterol 44±11 mg dl
−1) were included. Treatment periods of 6 weeks were separated by a 4-week washout period.
Results
: Both medications were tolerated well, no effects on serum concentrations of liver enzymes or immunosuppressive agents were observed. Cerivastatin and pravastatin decreased (
P
<0.001) cholesterol by 21±10% and 15±10%, LDL-cholesterol by 27±14% and 17±15%, respectively, while triglyceride and HDL-cholesterol concentrations did not change significantly. LDL/HDL-cholesterol markedly improved (
P
<0.001) by 29±16% (cerivastatin) and 16±16% (pravastatin). Cerivastatin was more potent than pravastatin in patients receiving cyclosporine A, while there was no significant difference in patients receiving tacrolimus.
Conclusions
: Low-dose cerivastatin and pravastatin significantly improve lipid profiles following liver transplantation without affecting liver function or immunosuppression.