Abstract
The most common side-effect of statins, mainly during dose titration, is liver toxicity, In these cases, sufficient control of low density lipoprotein cholesterol (LDL-C) in patients with heterozygous familial hypercholesterolaemia (HFH) becomes problematical. In patients with intolerance to resins as well, especially in the presence of coronary artery disease (CAD), it is practically impossible to reach the LDL-C treatment goal. This study included seven HFH patients with CAD, who presented with alanine amino transferase levels greater than three times the upper normal limit during dose titration of atorvastatin or simvastatin of from 20 mg/day to 40 mg/day. They could not tolerate concomitant cholestyramine administration, and presented with LDL-C levels significantly higher than the treatment goal (100 mg/dl; 2.6 mmol/l). In these patients, a combination of two statins with different pharmacokinetics (20 mg/day of atorvastatin plus 40mg/day of pravastatin) was administered for a mean period of one year. Efficacy was compared with that of monotherapy with each drug alone and with that of 40 mg of atorvastatin in 13 patients, who could also not tolerate resin co-administration, and that of 40 mg/day of atorvastatin plus 12 g o...Continue Reading
References
Jun 1, 1995·Journal of Cardiovascular Risk·J Heinrich, G Assmann
Mar 26, 1998·The American Journal of Cardiology·P JonesD Hunninghake
Jul 21, 1999·Journal of Cardiovascular Pharmacology·B TesfamariamR E Gregg
Jan 15, 2000·Arteriosclerosis, Thrombosis, and Vascular Biology·A H WagnerM Hecker
Mar 31, 2000·American Heart Journal·J D CohenA Labovitz
Sep 22, 2000·Atherosclerosis·S LopezG Nalbone
Sep 27, 2000·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·J A Farmer, G Torre-Amione
Oct 7, 2000·Stroke; a Journal of Cerebral Circulation·U LaufsM Endres
Nov 14, 2000·The American Journal of Cardiology·W C Cromwell, P E Ziajka
Dec 21, 2000·Current Atherosclerosis Reports·M H Davidson
Jan 4, 2001·The American Journal of Cardiology·R J FrostK G Parhofer
Feb 22, 2001·Circulation·Y FukumotoM Aikawa
Feb 24, 2001·Atherosclerosis·T NozueJ Koizumi
Mar 20, 2001·Atherosclerosis·R S RosensonE J Schaefer
Mar 28, 2001·Current Medical Research and Opinion·J A GoudevenosM S Elisaf
Apr 18, 2001·Circulation·I JialalS Devaraj
May 19, 2001·Acta Cardiologica·E MulsUNKNOWN LIPI-GOAL investigators
May 23, 2001·JAMA : the Journal of the American Medical Association·UNKNOWN Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults
May 29, 2001·American Heart Journal·R McPhersonUNKNOWN WATCH Investigators
Jun 28, 2001·Atherosclerosis·M ShiomiM Enomoto
Jul 24, 2001·Current Medical Research and Opinion·D R IllingworthUNKNOWN Simvastatin Atorvastatin HDL Study Group
Jul 27, 2001·The American Journal of Cardiology·J M McKenneyM L Watkins
Aug 18, 2001·BMJ : British Medical Journal·F Charatan
Aug 28, 2001·Biopharmaceutics & Drug Disposition·L H CohenS H Yap
Sep 12, 2001·Atherosclerosis·A KakafikaM Elisaf
Sep 26, 2001·Circulation·R SoRelle