EFFECTS OF GEMFIBROZIL (LOPID(R)) ON HYPERLIPIDEMIA IN ACITRETIN-TREATED PATIENTS - RESULTS OF A DOUBLE-BLIND CROSS-OVER STUDY

Hyperlipidemia is a common side-effect of oral retinoid treatment, whi ch sometimes interferes with long-term therapy. To evaluate the safety and efficacy of the lipid-lowering drug gemfibrozil on retinoid-assoc iated hyperlipidemia,we studied the clinical response and the plasma l ipoprotein levels in 22 acitretin-treated (0.25-0.75mg/kg) patients ma inly suffering from psoriasis. Gemfibrozil or placebo was given in a d ouble-blind cross-over fashion to 14 patients, who after 8 weeks of ac itretin therapy and dietary advice exhibited hyperlipidemia (triglycer ide levels greater than or equal to 50% above baseline and/or greater than or equal to 2.0 mmol/l). Serum triglycerides remained high (3.7+/ -2.4 mmol/l) during placebo treatment but were reduced after 8 weeks o f gemfibrozil treatment (p<0.01). The total cholesterol level decrease d slightly (p<0.05) during gemfibrozil treatment, but the LDL/HDL rati o did not change significantly. No untoward effects of gemfibrozil on acitretin dose-response and clinical side-effects were noted. Gemfibro zil thus appears useful in patients prone to retinoid-induced hyperlip idemia unresponsive to dietary treatment and acitretin dose reductions .