EFFECTS OF DECREASING DOSES OF GEMFIBROZIL IN MIDDLE-AGED AND ELDERLYDYSLIPIDEMIC PATIENTS - A MULTICENTER STUDY

The efficacy and tolerability of gemfibrozil, 600 mg twice daily for 1 2 weeks, followed by 900 mg once a day for 12 weeks, were evaluated in patients with primary hyperlipidemia. Of the 511 patients from 53 Ita lian centers, 393 were nondiabetic and 118 had non-insulin-dependent d iabetes mellitus. Twenty percent of the study population was 65 years of age or older. Both gemfibrozil regimens decreased total (TC) and lo w-density lipoprotein (LDL) cholesterol levels and increased high-dens ity lipoprotein (HDL) cholesterol concentration. Triglyceride levels w ere reduced, as were ratios of TC:HDL and LDL:HDL. Combined analysis o f the changes in lipid markers for coronary heart disease showed that gemfibrozil reduced the number of patients at highest risk, as defined by abnormalities in LDL:HDL ratio and triglycerides (lipid triad). At baseline, elderly patients had higher HDL and LDL levels and lower tr iglyceride levels than younger patients. Gemfibrozil therapy was equal ly effective in diabetic and nondiabetic patients and in both middle-a ged and older participants. Fasting blood glucose decreased in diabeti c patients who maintained fair control with oral hypoglycemic agents. Gemfibrozil was well tolerated; the incidence of clinical symptoms and laboratory deviations was minimal. Mild and transient digestive diffi culties were the most frequently reported adverse reactions but rarely resulted in interruption of the trial. A regimen of gemfibrozil 600 m g twice a day for 12 weeks followed by 900 mg once a day for 12 weeks was found to be safe and effective.