EFFECTS OF ATORVASTATIN ON SERUM-LIPIDS OF PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA

Objectives, The effects of atorvastatin, a new synthetic HMG-CoA reduc tase inhibitor, were investigated in patients with familial hyperchole sterolaemia (FH), with high LDLc levels whilst on standard treatment. Design. Open treatment with 40 mg atorvastatin daily for 6 weeks, foll owed by another 6 weeks with 80 mg atorvastatin. Setting. Outpatient l ipid clinic of a tertiary referral centre. Subjects. FH was diagnosed when the untreated LDLc concentration was higher than 6 mmol L-1, tend on xanthomas were present at the participant or a first degree relativ e, and the family history for hypercholesterolaemia was positive. The FH patients were selected for an LDLc above 5.0 mmol L-1 whilst on sta ndard therapy for at least 3 months. Standard therapy consisted of a d iet and 40 mg simvastatin, either alone (n = 17), or in combination wi th 8-12 g colestyramin (n = 12), or 1800 mg nicotinic acid (n = 12). M ain outcome measure. Effects on LDLc concentration. Results. LDLc conc entration significantly decreased during treatment with 80 mg atorvast atin as compared to LDLc levels on 40 mg simvastatin alone or in combi nation with 8-12 g colestyramin, by 24 +/- 14% (P < 0.01) and 19 +/- 2 2% (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 additio n to the treatment possibilities of patients with serious hypercholest erolaemia, like FH.