Enhanced low density lipoprotein cholesterol reduction and cost-effectiveness by low-dose colestipol plus lovastatin combination therapy

• Published in: The American journal of cardiology Vol. 75; no. 1; pp. 34 - 39
• Main Authors: Schrott, Helmut G., Stein, Evan A., Dujovne, Carlos A., Davidson, Michael H., Goris, George B., Oliphant, Thomas H., Phillips, Joann C., Shawaryn, Gregory G.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 1995; Elsevier; Elsevier Limited
• Subjects: Apolipoproteins - blood; Biological and medical sciences; Cholesterol; Cholesterol, LDL - blood; Colestipol - administration & dosage; Colestipol - therapeutic use; Cost-Benefit Analysis; Disorders of blood lipids. Hyperlipoproteinemia; Double-Blind Method; Drug therapy; Drug Therapy, Combination; Female; Humans; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Hypercholesterolemia - economics; Lipids - blood; Lipoproteins - blood; Lovastatin - administration & dosage; Lovastatin - therapeutic use; Male; Medical research; Medical sciences; Metabolic diseases; Middle Aged; Human; Chemotherapy; Hypercholesterolemia; Treatment; Cardiovascular disease; Metabolic diseases; Cholesterol LDL; Lipids; Hyperlipoproteinemia; Coronary heart disease; Cholesterol; Antilipemic agent
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/S0002-9149(99)80523-2

A total of 96 patients with moderate elevations of low-density lipoprotein (LDL) cholesterol were randomly assigned to 4 different double-blind treatment regimens: placebo; colestipol 5 g and lovastatin 20 mg/day (C5 + L20); colestipol 10 g and lovastatin 20 mg/day (C10 + L20); and lovastatin 40 mg/day (L40). During 12 weeks of therapy, C10 + L20 achieved the greatest reduction in total cholesterol (−32%) and LDL cholesterol (−48%) levels from baseline. This combination also exhibited significantly greater reductions in LDL cholesterol levels than the C5 + L20 and L40 groups (p <0.01). The differences in total and LDL cholesterol reduction between the C5 + L20 and L40 groups were not significant. Similar changes and differences between treatments were seen in apolipoprotein B levels. Whereas mean total opolipoprotein A-I levels increased with all treatments (p <0.05), lipoprotein particles A-I were significantly increased in the C10 + L20 group (p <0.01) only. Results demonstrate that the combination of low-dose lovastatin (20 mg/day) with low-dose colestipol (5 or 10 g/day) produces LDL cholesterol reductions equal to or greater than higher doses of lovastatin (40 mg/day). In addition, low-dose combinations are >25% more cost-effective than high-dose monotherapy.