PRAVASTATIN, CHOLESTYRAMINE, AND BEZAFIBRATE IN PATIENTS WITH HETEROZYGOUS FAMILIAL HYPERCHOLESTEROLEMIA - THE SPANISH MULTICENTER PRAVASTATIN STUDY

A 3-month, double-blind clinical trial, pravastatin 40 mg/day versus c holestyramine 16 mg/ day, with a 9-month, open-fashion extension [wher e cholestyramine 16 g/day and bezafibrate 400 mg h.s, were added to pr avastatin and cholestyramine, respectively, if total cholesterol (tota l-C) was > 7.8 mmol/dl after the double-blind study], was developed fo r 114 patients with heterozygous familial hypercholesterolemia (HFH). Average reductions in total-C and low-density lipoprotein cholesterol (LDL-C) at the end of the 12-month study were as follows: pravastatin: 24.8 and 32.1%; cholestyramine: 25.0 and 33.4%; pravastatin-cholestyr amine combination: 33.5 and 40.0%; and cholestyramine-bezafibrate comb ination: 17.2 and 19.2%. All treatments increased high-density lipopro tein cholesterol (HDL-C) and triglycerides rose in the cholestyramine group. Apolipoprotein Al, All, and B changed in parallel with HDL-C an d LDL-C concentrations. Seven patients discontinued the study: pravast atin: two patients; cholestyramine: three patients; one patient in eac h combination, Pravastatin, 40 mg/day alone or combined with cholestyr amine, is an effective and well tolerated treatment for HFH.