Combined para-aminosalicylic acid and dietary therapy in long-term control of hypercholesterolemia and hypertriglyceridemia (Types IIa and IIb hyperlipoproteinemia).

Abstract

SUMMARY The hypolipidemic effect of PAS-C-diet treatment was studied in 63 patients with Types Ila and IIb hyperlipoproteinemia for 6-36 months. Serum lipids and body weights of all patients were stabilized by a low cholesterol-saturated fat-refined carbohydrate diet before the initiation of an eight-week placebo-drug single-blind crossover study. During the placebo period the plasma lipids levels, mean ± SD: cholesterol 355 ± 63.5 mg%, triglyceride 141 ± 68.7 mg%, and LDL-cholesterol 279 ± 56.8 mg% were lowered to 274 ± 53.1 mg%, 98 ± 40.6 mg%, and 209 ± 52.9 mg%, respectively (P < 0.001 in each instance), with 7.5-11.0 grams of OF ALL THE HYPERLIPOPROTEINEMIC DIS-ORDERS, Types IIh, and "Ib have been shown to confer the highest risk of developing coronary artery disease'`6 and to be resistant to treatment.' I Although the beneficial effect of hypolipidemic therapy has not been conclusively determined, it is generally agreed that vigorous treatment aimed at lowering serum cholesterol and triglyceride concentrations might help to prevent or delay the occurrence of atherosclerotic complications.In using para-aminosalicylic acid (PAS) in antituberculous therapy, a number of observers have reported on its hypocholesterolemic effect.8'-The development of a highly purified preparation by recrystallizing the drug in vitamin C (PAS-C) has greatly improved its taste and absorption, while reducing its undesirable gastrointestinal effects of gastric irritation, diarrhea, and steatorrhea."' 1 'This report deals with the use of PAS-C in combination with diet in the attempt to: 1) achieve significant lowering of serum cholesterol and triglyceride levels in 63 patients with Type II hyperlipoproteinemia for 6-36 months, and 2) determine the side effects and acceptance of the drug by patients on a long-term basis. Patients and Methods of Study PatientsPatients were referred to the clinic because of resistant hypercholesterolemia with or without clinical ischemic heart or peripheral vascular disease. Affected family members of the propositi were diagnosed by screening. The age range DietTo prepare patients for the treatment, all of them were asked to sign an informed consent before they were given instruction to go on a low cholesterol and limited saturated fat-simple carbohydrate ("therapeutic") diet'5 with interruption of previous drug therapy for a minimum of four weeks.Adherence to the diet was periodically reviewed and patients were encouraged throughout the course of PAS-C treatment. MethodsIn single-blind crossover study, PAS-C and placebo administration were alternated with each successive patient entering the trial to form two groups. Sixty-three patients from two study groups who have completed the placebo period of the initial single-blind study and went on to take the drug for six or more months were included in this evaluation. Three baseline plasma lipid-lipoprotein determinations were made before the patient started to receive placebo or drug and at bi-weekly intervals afterward for four weeks. On starting PAS-C, ...

Effects of a glucoside-hydrolase inhibitor (Bay g 5421) on serum lipids, lipoproteins and bile acids, fecal fat and bacterial flora, and intestinal gas production in hyperlipidemic patients.

“…Para-aminosalicylic acid and dietary fiber are known to ameliorate the elevations of both VLDL and LDL. The hepatic as well as intestinal effects have been postulated for p-aminosalicylic acid (Barter et al 1974;Kuo et al 1976;Goldberg et al 1978). The effect on the intestine including bacterial flora and bile acids might be dominant for dietary fiber (Truswell and Kay 1976;Durrington et al 1976; Morris et al 1977).…”

Decreased bioavailability of digoxin due to hypocholesterolemic interventions.

“…Cholestyramine is an effective oral hypocholesterolemic agent which has been well documented to bind both digoxin and digitoxin in vitro.3 However, Hall and co-workers did not demonstrate any dramatic effect of cholestyramine upon digoxin absorption. 4 Para-aminosalicylic acid (PAS-C) also effectively lowers cholesterol.5 6 While it may not correlate directly with its hypocholesterolemic effect, induction of malabsorption is a proven effect of this drug. 7 Based on epidemiologic data, an association between atherosclerosis and a low intake of dietary fiber has been suggested.8 Like cholestyramine, these non-nutritive fibers have been shown to be adsorbent agents capable of binding such materials as bile salts.…”