[Comparison of the effectiveness of the HMG-CoA-reductase inhibitors pravastatin versus colestyramine in hypercholesteremia].

Comparison of the Efficacy of Pravastatin and Colestyramine in Hypercholesterolemic Patients. We have treated 55 patients with heterozygous familial hypercholesterolemia, familial combined and polygenic hyperlipoproteinemia in a controlled, randomized study to compare the efficacy of pravastatin (CAS 81093-37-0) and colestyramine (CAS 11041-12-6). After an initial therapy of 8 weeks with 20 mg pravastatin doubling of dose led to an additional decrease of the atherogenic lipid fractions (total cholesterol, TC) 21% versus 25%, LDL-C 26% versus 31%, Apo B 12% versus 17%). After 24 weeks of therapy TC decreased by 28%, LDL-C by 33% and Apo B by 14%. Colestyramine reduced cholesterol in 22 FH patients by mean 18%, LDL-C by mean 28% and Apo B by mean 12%. Both drugs did not differ significantly in their lipid-lowering potential. 16 g colestyramine and 20 mg pravastatin did not change the antiatherogenic lipids and apoproteins (HDL-C, Apo AI and AII), however, with 40 mg pravastatin HDL-C increased significantly by 8.4 to 16.5%. The triglycerides remained constant under colestyramine therapy. Pravastatin lowered serum triglycerides after 16 weeks significantly by 11-16%. Pravastatin had no significant effect on liver and kidney function or muscular metabolism. Under therapy with colestyramine well-known complaints like constipation or flatulence were rarely seen.