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September 1990

Effectiveness of Low-Dose Lovastatin in Lowering Serum Cholesterol: Experience With 56 Patients

Author Affiliations

From West Virginia University School of Medicine, Charleston Division, Charleston Area Medical Center. Dr Bates is now with the University of Kentucky Medical Center, Lexington.

Arch Intern Med. 1990;150(9):1947-1950. doi:10.1001/archinte.1990.00390200125023

• This study reviews the progress of 56 consecutive patients with type IIa and IIb hyperlipoproteinemia following treatment with lovastatin. Lovastatin, a potent inhibitor of 3-hydroxy-3-methylglutaryl coenzyme A reductase, has been shown to have a cholesterol-lowering effect in doses ranging from 10 to 80 mg/d. Thus far, however, no large study has been performed to show the effectiveness of low-dose lovastatin (20 mg/d) for more than a 6-week duration. Fifty-six patients with known coronary artery disease were prospectively studied, with fasting lipid values being measured at baseline and after 6,12,18, and 24 weeks of 20-mg/d lovastatin therapy given as a single evening dose. The total cholesterol level fell 26% from a mean baseline of 8.12 mmol/L (314 mg/dL) and triglyceride levels fell by 12% from a mean baseline of 2.46 mmol/L. The high-density lipoprotein levels increased 7.6%. One patient with known preexisting liver disease was withdrawn from the study owing to an asymptomatic significant rise in liver function test results; one subject complaining of proximal muscle weakness was also withdrawn. The maximal decrease in total cholesterol level occurred within 6 weeks of initiation of therapy. We conclude that low-dose (20-mg/d) lovastatin was effective in lowering serum cholesterol levels in patients with primary type IIa or IIb hyperlipoproteinemia with minimal short-term side effects. Further studies are needed to establish the long-term safety and effectiveness of this drug.

(Arch Intern Med. 1990;150:1947-1950)

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