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Keywords:

  • cholesterol;
  • familial hypercholesterolaemia;
  • HMG-CoA reductase inhibitors

Hoogerbrugge N (University Hospital Dijkzigt, Rotterdam, the Netherlands). Effects of atorvastatin on serum lipids of patients with familial hypercholesterolaemia. J Intern Med 1998; 244: 143–7.

Objectives

The effects of atorvastatin, a new synthetic HMG-CoA reductase inhibitor, were investigated in patients with familial hypercholesterolaemia (FH), with high LDLc levels whilst on standard treatment.

Design

Open treatment with 40 mg atorvastatin daily for 6 weeks, followed by another 6 weeks with 80 mg atorvastatin.

Setting

Outpatient lipid clinic of a tertiary referral centre.

Subjects

FH was diagnosed when the untreated LDLc concentration was higher than 6 mmol L−1, tendon xanthomas were present at the participant or a first degree relative, and the family history for hypercholesterolaemia was positive. The FH patients were selected for an LDLc above 5.0 mmol L−1 whilst on standard therapy for at least 3 months. Standard therapy consisted of a diet and 40 mg simvastatin, either alone (n= 17), or in combination with 8–12 g colestyramin (n= 12), or 1800 mg nicotinic acid (n= 12).

Main outcome measure

Effects on LDLc concentration.

Results

LDLc concentration significantly decreased during treatment with 80 mg atorvastatin as compared to LDLc levels on 40 mg simvastatin alone or in combination with 8–12 g colestyramin, by 24 ± 14% (P < 0.01) and 19 ± 22% (P < 0.01), respectively. LDLc concentration was comparable during treatment with 80 mg atorvastatin or 40 mg simvastatin in combination with 1800 mg nicotinic acid. Atorvastatin was tolerated well, no side-effects were observed.

Conclusions

Atorvastatin is a valuable addition to the treatment possibilities of patients with serious hypercholesterolaemia, like FH.