Efficacy of Low-Dose Cholesterol-Lowering Drug Therapy in Men With Moderate Hypercholesterolemia

Denke, Margo A.; Grundy, Scott M.

doi:10.1001/archinte.1995.00430040067008

Cited by 27 publications

(6 citation statements)

References 28 publications

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“…The resulting decrease in the hepatocyte cholesterol content enhances LDL receptor expression, which in turn lowers serum LDL-C concentrations. The first major clinical study to demonstrate that primary prevention reduced coronary events, the Lipid Research Clinics Coronary Primary Prevention Trial, used the bile acid sequestrant cholestyramine [68,69]. Added to statins, sequestrants achieve a greater reduction in LDL levels than doubling the dose of a statin [68,70,71].…”

Section: Dyslipidemia Treatmentmentioning

confidence: 99%

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Omran¹,

Al-Dadah

Dellsperger³

2013

Cardiorenal Med

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In this review, we discuss the physiology, diagnosis and treatment of dyslipidemia in patients with chronic and end-stage renal disease. The recent important clinical trials in patients with chronic kidney disease and dyslipidemia are reviewed. Because of the lack of evidence in treating lipid abnormalities in this specific patient population, we propose that future studies should focus on the pathophysiological mechanisms and treatment of dyslipidemia in this special patient population.

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Section: Dyslipidemia Treatmentmentioning

confidence: 99%

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Omran¹,

Al-Dadah

Dellsperger³

2013

Cardiorenal Med

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“…This allows clinicians to design combination regimens that effectively lower LDL with low, tolerable, and safe dosages. 39,40 Finally, when substantial LDL lowering is required, a triple-drug regimen may be tried. For example, lowering LDL 60% (from baseline of 215 mg/dl to a mean of 85 mg/dl) was reported with the combination of a statin, niacin, and BAS; 83% of patients achieved their LDL goal of less than 100 mg/dl.…”

Section: Combination Therapymentioning

confidence: 99%

New Cholesterol Guidelines, New Treatment Challenges

McKenney

2002

Pharmacotherapy

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Coronary heart disease (CHD) is the largest single killer of Americans. Epidemiologic trials have indicted low-density lipoprotein cholesterol (LDL) as directly correlating with CHD events, and clinical trials confirmed that lipid-lowering therapy decreases the risk of CHD events. The literature also indicates that only about 18% of these patients are treated to their goal LDL levels. New guidelines from the National Cholesterol Education Program extend the LDL-lowering recommendations, add a new non-high-density lipoprotein cholesterol (non-HDL) goal for patients with hypertriglyceridemia, and increase the number of drug-eligible patients from about 15 to 36 million. Most of those who are eligible for lipid-altering drug therapy have the highest CHD risk and require the most aggressive treatment to achieve goals. This presents a challenge to clinicians: how best to achieve LDL and non-HDL goals. Statins are the most effective agents for lowering LDL and one of the most effective for lowering non-HDL. This efficacy and the ability to reduce CHD risk were well documented in a number of randomized clinical trials. When statin monotherapy fails to achieve goals, a bile acid resin, niacin, or both may be added to lower LDL further, or a fibrate, niacin, or fish oils may be added to lower non-HDL further. Drugs are under development that may enhance our ability to reach LDL and non-HDL goals. Included are a group of so-called super statins, rosuvastatin and pitavastatin; agents that interfere with cholesterol or bile acid transport in the gut, such as ezetimibe; and dual peroxisome proliferator-activated receptor agonists that have both fibrate and thiazolidinedione-like effects.

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“…Despite this, the limitations of statin therapy in patients with severe hypercholesterolemia in whom a minimum of 50% LDL-C lowering was needed, were soon appreciated. Several studies were published in the early 1990s demonstrating the value of add-on cholestyramine or colestipol to treatment with, pravastatin, 15 fl uvastatin 16 and lovastatin, 17 in which approximately 50% lowering of LDL-C and up to 40% lowering of apo B 18 was achieved. Furthermore combination of these agents with non-statin drugs such as niacin 19 or fi brates 20 provided added LDL-C-lowering capability to triglyceride-lowering or HDL-C-raising agents, without the safety concerns that had been raised by combined use of these drugs with statins.…”

Section: Initial Use Of Bile Acid Sequestrants As Ldl-c-lowering Agentsmentioning

confidence: 99%

Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam – a clinical perspective

Goldberg¹

2009

DMSO

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Bile sequestrants have been used for almost 50 years to lower low density lipoprotein cholesterol (LDL-C). The advent of colesevelam in 2000 provided a more tolerable add-on LDL-C-lowering agent with an excellent safety record and with likely benefi t for coronary heart disease events. Colesevelam lowers LDL-C approximately 15%, and has an additive effect when combined with statin or non-statin lipid-modifying agents. It also tends to increase triglyceride levels. The discovery that bile sequestrants also lower glucose levels led to defi nitive large-scale clinical trials testing the effect of colesevelam as a dual antihyperglycemic agent with LDL-Clowering properties in type 2 diabetic subjects on metformin-, sulfonylurea-or insulin-based therapy with inadequate glycemic control. Colesevelam was found to lower hemoglobin A1c (HbA1c) by approximately 0.5% compared to placebo over the 16-to 26-week period, and had similar effects on the lipid profi le in these diabetic subjects, as had previously been demonstrated in non-diabetic individuals. Colesevelam was well tolerated, with constipation being the most common adverse effect, and did not cause weight gain or excessive hypoglycemia. Colesevelam thus combines antihyperglycemic action with LDL-C-lowering properties, and should be useful in the management of type 2 diabetes.

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Efficacy of Low-Dose Cholesterol-Lowering Drug Therapy in Men With Moderate Hypercholesterolemia

Abstract: Low-dose combination drug therapy for the management of hypercholesterolemia appears to be an effective means of lowering cholesterol levels that remain persistently elevated after dietary therapy, at the same time, it should carry a low risk of toxic effects.

Cited by 27 publications

References 28 publications

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

New Cholesterol Guidelines, New Treatment Challenges

Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam – a clinical perspective

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Efficacy of Low-Dose Cholesterol-Lowering Drug Therapy in Men With Moderate Hypercholesterolemia

Abstract: Low-dose combination drug therapy for the management of hypercholesterolemia appears to be an effective means of lowering cholesterol levels that remain persistently elevated after dietary therapy, at the same time, it should carry a low risk of toxic effects.

Cited by 27 publications

References 28 publications

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

New Cholesterol Guidelines, New Treatment Challenges

Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam &ndash; a clinical perspective

Contact Info

Product

Resources

About

Improving glycemic and cholesterol control through an integrated approach incorporating colesevelam – a clinical perspective