Lovastatin wins cholesterol battle.

Lovastatin wins cholesterol battle

In the first large clinical study comparing two of the major drugs used to treat high serum cholesterol, researchers have concluded that lovastatin, a new drug approved last September (SN: 9/12/87, p.166), works more effectively and causes fewer side effects than the standard cholestyramine resin therapy. The drugs are among the six approved for use in lowering the level of low-density lipoprotein (LDL) cholesterol in the bloodstream. High LDL levels are believed to contribute to heart disease in some people.

Involving 264 men and women from 12 clinical centers across the United States, the study was coordinated by Merck, Sharp & Dohme of West Point, Pa., which makes lovastatin. Researchers found the average LDL cholesterol level dropped by 32 percent when a 20-milligram dose of lovastatin was given twice a day for 12 weeks. Patients experienced a 42 percent average reduction in LDL cholesterol after taking a 40-milligram dose over the same period. For patients taking cholestyramine resin, researchers reported a 23 percent lower LDL level after 12 grams of cholestyramine resin therapy twice a day (the maximum recommended dosage) for the same 12 weeks. All groups saw 85 percent of the reduction within two weeks after the study began.

Writing in the July 15 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, the researchers report that only one serious side effect -- regional muscle pain experienced by a 65-year-old woman in the 40-mg dosage group--was thought to be directly linked to lovastatin, and ended when the patient stopped taking the drug. Less serious effects, such as constipation, were more common in the cholestyramine resin therapy group.

Both drugs slightly increased patients' levels of high-density lipoprotein cholesterol -- the so called "good cholesterol" that appears to protect against heart disease.

"Our study clearly demonstrates that lovastatin is both considerably more effective and much better tolerated than cholestyramine resin therapy," the researchers state. They recommend further testing on one aspect of the study: Women seemed to respond to lovastatin better than men, although there were no gender differences in responses to cholestyramine resin therapy.