Normalization of plasma lipoprotein concentrations in patients with type II hyperlipoproteinemia by combined use of neomycin and niacin.

Hoeg, Jeffrey M.; Maher, Martha B.; Bou, Ernestina; Zech, Loren A.; Bailey, Kent R.; Gregg, Richard E.; Sprecher, Dennis L.; Susser, J K; Pikus, Anita; Brewer, H. Bryan

doi:10.1161/01.cir.70.6.1004

Cited by 37 publications

(8 citation statements)

References 19 publications

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“…Because neomycin addition in this study [7] was ineffective it was concluded that neomycin and resin may have similar mechanisms of action. Neomycin with niacin decreased serum LDL cholesterol (by 45 %) [6] as effectively as statin plus neomycin in the present study, but the former combination also decreased serum triglycerides by 33% and increased HDL cholesterol by 34 %. Moreover, lovastatin plus nicotinic acid resulted in a 50 % reduction of LDL cholesterol [46].…”

Section: Discussioncontrasting

confidence: 45%

“…Inhibition of cholesterol absorption is a very effective method of lowering elevated serum cholesterol levels [5]. A combination of neomycin with cholestyramine results in a marked reduction in serum cholesterol by linking the two different mechanisms of cholesterol and bile acid malabsorption [4,6,7]. Both neomycin [8][9][10] and sitostanol [11,12] reduce cholesterol absorption in the intestine.…”

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confidence: 99%

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Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients

Vanhanen

1994

Eur J Clin Pharmacol

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Serum cholesterol values were insufficiently reduced by pravastatin in two different patient populations. Therefore, we studied whether further cholesterol reduction could be achieved by inhibiting both cholesterol synthesis (by pravastatin) and absorption (by neomycin or sitostanol ester). Thus, we measured serum cholesterol, cholesterol precursors (reflecting cholesterol synthesis), cholestanol and plant sterols (reflecting cholesterol absorption and biliary secretion) for up to 6 weeks in pravastatin-treated patients with familial hypercholesterolaemia (FH, n = 13) and with and without ileal bypass during addition of neomycin (1.5 g per day) and in another patient population of non-FH (n = 14) subjects during addition of sitostanol ester (1.5 g per day). Addition of neomycin lowered serum total, LDL and HDL cholesterol by a further 20%, and increased the pravastatin-lowered precursor:cholesterol ratios by 20% (irrespective of ileal bypass). It also reduced by 20% the plant sterol:cholesterol ratio (irrespective of ileal bypass) which was markedly increased by pravastatin alone. Pravastatin and neomycin in combination lowered total, LDL and HDL cholesterol by 45%, 53% and 17%, respectively. This combined regimen reduced the serum lathosterol:cholesterol ratio to about half of the reduction caused by pravastatin, while the elevation of the plant sterols:cholesterol ratio was less with the combination than with pravastatin alone. Changes in serum cholesterol precursor:cholesterol and plant sterol:cholesterol ratios during the combined treatment were smaller in the subgroup with ileal bypass. Addition of sitostanol ester did not lower serum total or LDL cholesterol nor the precursor:cholesterol ratios significantly, while the reduction observed in the plant sterols:cholesterol ratios was similar to that achieved with neomycin addition.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussioncontrasting

confidence: 45%

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confidence: 99%

Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients

Vanhanen

1994

Eur J Clin Pharmacol

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“…The fasting total, LDL, and high-density lipoprotein (HDL) cholesterol concentrations were determined by enzymatic assays as outlined previously, 29 and the concentration of lipoprotein(a) [Lp(a)] was determined by a sandwich enzyme-linked immunosorbent assay as previously described. 30 Because of the profound elevations in the concentrations of atherogenic lipoprotein particles, these patients have received a number of therapies, including a variety of hypolipidemic medications, ileal bypass, liver transplantation, LDL apheresis, and plasma exchange.…”

Section: Lipoprotein Assaysmentioning

confidence: 99%

Detection and quantitation of calcific atherosclerosis by ultrafast computed tomography in children and young adults with homozygous familial hypercholesterolemia.

Hoeg

Feuerstein

Tucker

1994

Arterioscler Thromb

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113

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Ultrafast computed tomography (CT) is a new method for detecting calcific lesions in the coronary arteries. The ability of CT to detect and quantify coronary artery atherosclerosis in children and young adults at risk for malignant atherogenesis was evaluated. A total of 11 consecutive familial hypercholesterolemic (FH) homozygotes (3 to 37 years old) participated. Untreated total cholesterol concentrations were 488 to 1277 mg/dL (12.7 to 33.2 mmol/L). Angiography detected significant lesions in 7 of 11 patients. CT detected calcific atherosclerosis in all 9 of the patients older than 12 years of age, including all those with angina. CT was more sensitive in detecting aortic root and coronary ostial lesions, where atherosclerosis first appears in homozygous FH. The volume of calcification (in cubic millimeters) correlated T he inborn error in cholesterol metabolism that has provided the greatest insight into the role of low-density lipoprotein (LDL) cholesterol in human atherosclerosis is that of familial hypercholesterolemia (FH). More than 150 specific mutations in the LDL receptor gene have been identified that lead to deranged clearance of atherogenic, cholesteryl esterrich LDL particles from the circulation.

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“…Administered in a 1 g dialy dose, neomycin may lower LDL cholesterol levels (mean reduction 21 %). 140,141 Owing to its possible nephro-and ototoxicity, more work must be performed to properly evaluate its use in hyperlipidemic disorders, however.…”

Section: Second-line Hypolipidemic Drugsmentioning

confidence: 99%

Pharmacological treatment of lipid disorders in diabetes mellitus

Lopes‐Virella

Colwell

1987

Diabetes Metab. Rev.

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Normalization of plasma lipoprotein concentrations in patients with type II hyperlipoproteinemia by combined use of neomycin and niacin.

Cited by 37 publications

References 19 publications

Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients

Cholesterol malabsorption caused by sitostanol ester feeding and neomycin in pravastatin-treated hypercholesterolaemic patients

Detection and quantitation of calcific atherosclerosis by ultrafast computed tomography in children and young adults with homozygous familial hypercholesterolemia.

Pharmacological treatment of lipid disorders in diabetes mellitus

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