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Recent prospective clinical trials have established that cholesterol reduction in patients with elevated (upper 90th percentile) concentrations of low-density lipoproteins (LDL) reduces the incidence of myocardial infarction and sudden death. Because the level of protection from these cardiovascular sequelae is directly related to the degree of LDL reduction, combination therapy using different hypolipidemic agents has been used in patients with type II hyperlipoproteinemia (HLP). Neomycin is as effective as cholestyramine in reducing LDL levels and combination neomycin-niacin treatment normalizes the plasma lipoproteins in 92% of patients with type II HLP. Because neomycin could theoretically ameliorate some of the gastrointestinal side effects of cholestyramine in addition to further affecting cholesterol levels, the effects of combination cholestyramine-neomycin treatment on the plasma lipoprotein were assessed in 18 patients with type II HLP in a 9-month clinical trial. Compared with diet-only treatment, cholestyramine reduced total and LDL cholesterol levels by 77 mg/dl (22%) and 78 mg/dl (31%), respectively. In addition to relieving cholestyramine-induced constipation, neomycin further reduced the total cholesterol level by 20 mg/dl (6%). However, this further reduction in total cholesterol concentration was the result of a decrease in the concentration of high-density lipoprotein cholesterol. These findings indicate that combination therapy does not have an additive LDL cholesterol-lowering effect and that neomycin and cholestyramine is not a useful drug combination. In addition, these results illustrate the importance of determining the high-density lipoprotein cholesterol concentration to fully interpret the effects of hypolipidemic treatment.
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
January 1978,
Atherosclerosis,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
October 1984,
Clinical pharmacology and therapeutics,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
December 1971,
Ugeskrift for laeger,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
January 1986,
Drug-nutrient interactions,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
November 1972,
JAMA,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
July 1973,
Annals of internal medicine,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
July 1979,
Atherosclerosis,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
January 1976,
Acta medica Scandinavica,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
January 1976,
Vnitrni lekarstvi,
J M Hoeg, and
M B Maher, and
K R Bailey, and
L A Zech, and
R E Gregg, and
D L Sprecher, and
H B Brewer
January 1978,
Therapie,
