ENHANCED LOW-DENSITY-LIPOPROTEIN CHOLESTEROL REDUCTION AND COST-EFFECTIVENESS BY LOW-DOSE COLESTIPOL PLUS LOVASTATIN COMBINATION THERAPY

A total of 96 patients with moderate elevations of low-density lipopro tein (LDL) cholesterol were randomly assigned to 4 different double-bl ind treatment regimens: placebo; colestipol 5 g and lovastatin 20 mg/d ay (C5 + L20); colestipol 10 g and lovastatin 20 mg/day (C10 + L20); a nd lovastatin 40 mg/day (L40). During 12 weeks of therapy, C10 + L20 a chieved the greatest reduction in total cholesterol (-32%) and LDL cho lesterol (-43%) levels from baseline. This combination also exhibited significantly greater reductions in LDL cholesterol levels than the C5 + L20 and L40 groups (p <0.01). The differences in total and LDL chol esterol reduction between the C5 + L20 and L40 groups were not signifi cant. Similar changes and differences between treatments were seen in apolipoprotein B levels, Whereas mean total apolipoprotein A-I levels increased with all treatments (p <0.05), lipoprotein particles A-I wer e significantly increased in the C10 + L20 group (p <0.01) only, Resul ts demonstrate that the combination of low-dose lovastatin (20 mg/day) with low-dose colestipol (5 or 10 g/day) produces LDL cholesterol red uctions equal to or greater than higher doses of lovastatin (40 mg/day ). In addition, low-dose combinations are >25% more cost-effective tha n high-dose monotherapy.