Efficacy and Safety of Coadministration of Rosuvastatin, Ezetimibe, and Colestimide in Heterozygous Familial Hypercholesterolemia

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• 作者：Masa-aki Kawashiri ; MD^a ; ^d ; ^{mk@med.kanazawa-u.ac.jp} ; Atsushi Nohara ; MD^b ; Tohru Noguchi ; PhD^b ; Hayato Tada ; MD^a ; Chiaki Nakanishi ; MD^a ; Mika Mori ; MD^a ; Tetsuo Konno ; MD^a ; Kenshi Hayashi ; MD^a ; Noboru Fujino ; MD^a ; Akihiro Inazu ; MD^c ; Junji Kobayashi ; MD^b ; Hiroshi Mabuchi ; MD^b ; Masakazu Yamagishi ; MD^a
• 刊名：The American Journal of Cardiology
• 出版年：2012
• 出版时间：1 February 2012
• 年：2012
• 卷：109
• 期：3
• 页码：364-369
• 全文大小：486 K

文摘

Aggressive low-density lipoprotein (LDL) cholesterol-lowering therapy is important for high-risk patients. However, sparse data exist on the impact of combined aggressive LDL cholesterol-lowering therapy in familial hypercholesterolemia (FH), particularly on side effects to changes in plasma coenzyme Q10 and proprotein convertase subtilisin/kexin type 9 levels. We enrolled 17 Japanese patients with heterozygous FH (12 men, 63.9 ¡À 7.4 years old) with single LDL receptor gene mutations in a prospective open randomized study. Permitted maximum doses of rosuvastatin (20 mg/day), ezetimibe (10 mg/day), and granulated colestimide (3.62 g/day) were introduced sequentially. Serum levels of LDL cholesterol decreased significantly by ?6.4 % (p <0.001) and 44 % of participants achieved LDL cholesterol levels <100 mg/dl. There were no serious side effects or abnormal laboratory data that would have required the protocol to have been terminated except for 1 patient with myalgia. Coadministration of ezetimibe and granulated colestimide further lowered serum LDL cholesterol more than rosuvastatin alone without changing plasma coenzyme Q10 and proprotein convertase subtilisin/kexin type 9 levels. In conclusion, adequate introduction of this aggressive cholesterol-lowering regimen can improve the lipid profile of FH.