Effect of colestipol and clofibrate, singly and in combination, on plasma lipid and lipoproteins in Type IIb hyperlipoproteinemia

Abstract

The effect of colestipol, clofibrate and a combination of these two drugs on plasma lipid and lipoprotein levels was evaluated in 14 adult male patients with Type IIb hyperlipoproteinemia. A crossover design with each patient receiving all three treatments was utilized. Twenty g of colestipol per day reduced total and LDL cholesterol by 39.1 and 51.5 mg/dl, respectively (p < 0.001). There was an associated rise in total triglycerides of 63.5 mg/dl (p < 0.01) with no significant change in HDL cholesterol. Clofibrate, 2.0 g per day, did not significantly lower either total (−7.9 mg/dl) or LDL cholesterol (+8.7 mg/dl). There was marked interpatient variability in terms of the LDL cholesterol response to clofibrate, but the majority of patients demonstrated an increase. HDL cholesterol levels increased by 6.7 mg/dl (p < 0.01) and total triglycerides were reduced by 94.6 mg/dl (p < 0.001). Utilizing the same dosages of both drugs, the combination of colestipol and clofibrate was less effective in lowering total and LDL cholesterol than colestipol therapy alone, and increases in HDL cholesterol and decreases in triglycerides similar to those obtained with clofibrate were observed.