Low‐dose combination therapy with colesevelam hydrochloride and lovastatin effectively decreases low‐density lipoprotein cholesterol in patients with primary hypercholesterolemia

Davidson, Michael; Toth, Phillip D.; Weiss, Stuart; McKenney, James M.; Hunninghake, Donald B.; Isaacsohn, Jonathan L.; Donovan, Joanne M.; Burke, Steven K.

doi:10.1002/clc.4960240610

Cited by 97 publications

(73 citation statements)

References 34 publications

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“…The influence of viscous fiber intake on the LDL-C level is due, at least in part, to inhibition of intestinal absorption/reabsorption of cholesterol and, to a lesser extent, bile acids (Carr et al, 1996;Reppas et al, 2009). The effects of plant sterols and stanols, bile acid sequestrants (for example, colesevelam HCl) and cholesterol absorption inhibitors (for example, ezetimibe) on LDL-C also appear to be additive to the effects of statin therapy (Davidson et al, 2001;Ballantyne et al, 2005;Pearson et al, 2005;Castro Cabezas et al, 2006;Goldberg et al, 2006). The consistency of results across studies suggests that agents that work through interference with the enterohepatic circulation of cholesterol and bile acids produce effects on LDL-C that are directly additive to those of statins.…”

Section: Discussionmentioning

confidence: 99%

Hydroxypropylmethylcellulose lowers cholesterol in statin-treated men and women with primary hypercholesterolemia

et al. 2009

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Background/Objectives: Consumption of hydroxypropylmethylcellulose (HPMC), a viscous dietary fiber, lowers total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). However, HPMC had not previously been studied in individuals receiving lipid drug therapy. Subjects/Methods: This randomized, double-blind crossover trial examined the lipid effects of HPMC in subjects with hypercholesterolemia on statin therapy. Men (n ¼ 5) and women (n ¼ 8) with LDL-CX2.59 mmol/l after at least 4 weeks of stable-dose statin therapy, and a mean age of 58.6 years, were enrolled. Subjects received twice daily doses of either 2.5 g HPMC or control, delivered in a lemonade beverage for 4 weeks, then crossed over to receive the opposite treatment for an additional 4 weeks. Results: Mean baseline concentrations of TC, non-high-density lipoprotein cholesterol (non-HDL-C), LDL-C, HDL-C, triglyceride (TG), TC/HDL-C ratio and apolipoprotein (Apo) B were 4.95, 3.63, 3.03, 1.33, 1.30 and 3.89 mmol/l and 1.00 g/l, respectively. HPMC consumption resulted in significantly larger reductions (Po0.01 vs control for all) in TC (À10.9 vs À3.5%), non-HDL-C (À12.8 vs À2.9%), LDL-C (À15.7 vs À5.1%), TC/HDL-C ratio (À5.3 vs þ 1.3%) and Apo B (À8.7 vs À3.9%). There were no differences between treatments for changes in HDL-C (À5.2 vs À4.3%) or TG ( þ 3.9 vs þ 8.9%). Conclusions: These results support the view that HPMC is an effective adjunct to statin therapy for further lowering atherogenic lipids and lipoproteins in men and women with primary hypercholesterolemia.

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Section: Discussionmentioning

confidence: 99%

Hydroxypropylmethylcellulose lowers cholesterol in statin-treated men and women with primary hypercholesterolemia

et al. 2009

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“…The first major clinical study to demonstrate that primary prevention reduced coronary events, the Lipid Research Clinics Coronary Primary Prevention Trial, used the bile acid sequestrant cholestyramine [68,69]. Added to statins, sequestrants achieve a greater reduction in LDL levels than doubling the dose of a statin [68,70,71]. …”

Section: Dyslipidemia Treatmentmentioning

confidence: 99%

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Omran¹,

Al-Dadah

Dellsperger³

2013

Cardiorenal Med

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In this review, we discuss the physiology, diagnosis and treatment of dyslipidemia in patients with chronic and end-stage renal disease. The recent important clinical trials in patients with chronic kidney disease and dyslipidemia are reviewed. Because of the lack of evidence in treating lipid abnormalities in this specific patient population, we propose that future studies should focus on the pathophysiological mechanisms and treatment of dyslipidemia in this special patient population.

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“…49 Mean serum LDL-c levels were reduced by 32% to 34% in both combination therapy groups compared to monotherapy with colesevelam or lovastatin (−7% versus −22%, respectively). A significant increase in serum HDL-c levels occurred only in the colesevelam monotherapy group (5%).…”

Section: Combination With Statinsmentioning

confidence: 89%

“…Colesevelam also decreased C-reactive protein by 19% and LDL-particle number by 14% in the single trials in which they were measured. 49 Davidson et al, in a multicenter, randomized clinical trial, demonstrated a dose-dependent LDL-c reduction from baseline in the colesevelam groups (−2% to −19%).…”

Section: Efficacy Monotherapymentioning

confidence: 94%

Current and Emerging Therapies in Hypercholesterolemia: Focus on Colesevelam

2010

Clinical Medicine Reviews in Vascular Health

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Background: Statins are recommended as first line therapy for the prevention of cardiovascular disease. Some individuals are statin intolerant or may need additional cholesterol lowering to achieve their cholesterol targets. Purpose: To review the pharmacology, clinical efficacy and safety of colesevelam mono-and combination therapy in patients with hypercholesterolemia. Data source: English-language journals from PUBMED MEDLINE (without restriction of date) using key word colesevelam. Results: Trials of colesevelam as monotherpy or in combination had baseline LDL-c levels of 130 to 202 mg/dl and triglycerides levels of 114 to 230 mg/dl. Colesevelam monotherapy reduced LDL-c by 9%-20% while increasing triglycerides 6%-25%. When added to low or moderate dose statin therapy, colesevelam decreased LDL-c an additional 6%-16%; when added to fenofibrate, colesevelam additionally decreased LDL-c by 17% and non-HDL-c by 7%; and when added to statin + niacin 2 gr additionally decreased LDL-c by 10%. The hypertriglyceridemia observed with colesevelam monotherapy was largely attenuated when colesevelam was coadministered with statins, fenofibrate, or niacin 2 gr. Coadministration of colesevelam with ezetimibe provided variable additional LDL-c reductions ranging from 0 to 20% over ezetimibe alone, and triglyceride responses were similarly variable. In diabetic individuals with modest hypertriglyceridemia, colesevelam reduced hemoglobin A1c by 0.5%. Colesevelam has fewer drug interactions than older bile acid sequestrants and is well-tolerated when used in combination with other lipid-lowering medications as well as with oral anti-diabetes medications or insulin. Conclusion: Colesevelam is an option for patients who have not achieved their LDL-c and non-HDL-c goals with statin therapy, or who are statin intolerant. Colesevelam is also an option to lower both LDL-c and glucose levels in patients with inadequately controlled diabetes.

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Low‐dose combination therapy with colesevelam hydrochloride and lovastatin effectively decreases low‐density lipoprotein cholesterol in patients with primary hypercholesterolemia

Cited by 97 publications

References 34 publications

Hydroxypropylmethylcellulose lowers cholesterol in statin-treated men and women with primary hypercholesterolemia

Hydroxypropylmethylcellulose lowers cholesterol in statin-treated men and women with primary hypercholesterolemia

Dyslipidemia in Patients with Chronic and End-Stage Kidney Disease

Current and Emerging Therapies in Hypercholesterolemia: Focus on Colesevelam

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