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Vol. 5, No. 1, 2005
Issue release date: January–March 2005

The Era of Statins – Is There Still a Place for Other Classes of Lipid-Lowering Drugs?

Wascher T.C.
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Abstract

Plenty of evidence suggests statins as the first-line therapy for the treatment of lipid disorders. However, further therapeutic options available in the treatment of lipid disorders are fibrates, niacin and cholesterol absorption inhibitors. In the present study, current treatment modalities of lipid disorders are reviewed, and their use was scrutinized based on the available evidence.



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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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References

  1. Kannel WB, Castelli WP, Gordon T, McNamara PM: Serum cholesterol, lipoproteins, and the risk of coronary heart disease: The Framingham study. Ann Intern Med 1971;74:1–12.
  2. Verschuren WM, Jacobs DR, Bloemberg BP, Kromhout D, Menotti A, Aravanis C, Blackburn H, Buzina R, Dontas AS, Fidanza F: Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow-up of the seven countries study. JAMA 1995;274:131–136.
  3. Ross R, Agius L: The process of atherogenesis – Cellular and molecular interaction: From experimental animal models to humans. Diabetologia 1992;35(suppl 2):S34–S40.

    External Resources

  4. Jukema JW, Bruschke AVG, van Boven AJ, Reiber JHC, Bal ET, Zwinderman AH, Jansen H, Boerma GJM, van Rappard FM, Lie KI: Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. Circulation 1995;91:2528–2540.
  5. Waters D, Higginson L, Gladstone P, Kimball B, LeMay M, Boccuzzi S, Lesperance J, CCAIT Study Group: Effects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography. Circulation 1993;89:959–968.
  6. Group SSss: Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin survival study. Lancet 1994;344:1383–1389.
  7. Altmann SW, Davis HR, Zhu LJ, Yao X, Hoos LM, Tetzloff G, Iyer SP, Maguire M, Golovko A, Zeng M, Wang L, Murgolo N, Graziano MP: Niemann-Pick C1 like 1 protein is critical for intestinal cholesterol absorption. Science 2004;303:1149–1150.
  8. Lipka LJ: Ezetimibe: A first-in-class, novel cholesterol absorption inhibitor. Cardiovasc Drug Rev 2003;21:293–312.
  9. Cannon CP, Braunwald E, McCabe CH, Rader DJ, Rouleau JL, Belder R, Joyal SV, Hill KA, Pfeffer MA, Skene AM: Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004;350:1495–1504.
  10. Duval C, Fruchart JC, Staels B: PPAR alpha, fibrates, lipid metabolism and inflammation. Arch Mal Coeur Vaiss 2004;97:665–672.
  11. Ruotolo G, Ericsson CG, Tettamanti C, Karpe F, Grip L, Svane B, Nilsson J, DeFaire U, Hamsten A: Treatment effects on serum lipoprotein lipids, apolipoproteins and low density lipoprotein particle size and relationships of lipoprotein variables to progression of coronary artery disease in the bezafibrate coronary atherosclerosis intervention trial (BECAIT). J Am Coll Cardiol 1998;32:1648–1656.
  12. Avogaro A, Beltramello P, Marin R, Zampon S, Bonanome A, Biffanti S, Confortin L, Manzato E, Crepaldi G, Tiengo A: Insulin action and glucose metabolism are improved by gemfibrozil treatment in hypertriglyceridemic patients. Atherosclerosis 1995;113:117–124.
  13. Frick MH, Elo O, Haapa K, Heinonen OP, Heinsalmi P, Helo P, Huttunen JK, Kaitaniemi P, Koskinen P, Manninen V: Helsinki Heart Study: Primary prevention trial with gemfibrozil in middle-aged men with dyslipidemia. Safety of treatment, changes in risk factors, and incidence of coronary heart disease. N Engl J Med 1987;317:1237–1245.
  14. The BIP Study Group: Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease: The Bezafibrate Infarction Prevention (BIP) study. Circulation 2000;102:21–27.

    External Resources

  15. Rubins HB, Robins SJ, Collins D, Fye CL, Anderson JW, Elam MB, Faas FH, Linares E, Schaeffer EJ, Schectman G, Wilt TJ, Wittes J: Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol. N Engl J Med 1999;341:410–418.
  16. Tenkanen L, Manttari M, Manninen V: Some coronary risk factors related to the insulin resistance syndrome and treatment with gemfibrozil. Experience from the Helsinki Heart Study. Circulation 1995;92:1779–1785.
  17. Ballantyne CM, Ollson AG, Cook TJ, Mercuri MF, Pedersen TR, Kjekshus J: Influence of low high-density lipoprotein cholesterol and elevated triglyceride on coronary heart disease events and response to simvastatin therapy in 4S. Circulation 2001;104:3046–3051.
  18. Thompson PD, Clarkson P, Karas RH: Statin-associated myopathy. JAMA 2003;289:1681–1690.
  19. Kamanna VS, Kashyap ML: Mechanism of action of niacin on lipoprotein metabolism. Curr Atheroscler Rep 2000;2:36–46.
  20. Pike NB, Wise A: Identification of a nicotinic acid receptor: Is this the molecular target for the oldest lipid-lowering drug? Curr Opin Investig Drugs 2004;5:271–275.
  21. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W: Fifteen year mortality in Coronary Drug Project patients: Long-term benefit with niacin. J Am Coll Cardiol 1986;8:1245–1255.
  22. Brown BG, Zhao XQ, Chait A, Fisher LD, Cheung MC, Morse JS, Dowdy AA, Marino EK, Bolson EL, Alaupovic P, Frohlich J, Albers JJ: Simvastatin and niacin, antioxidant vitamins or the combination for the prevention of coronary disease. N Engl J Med 2001;345:1583–1592.
  23. Shepherd J, Cobbe M, Ford I, Group WCPS: Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995;333:1301–1307.
  24. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, Langendorfer A, Stein EA, Kruyer W, Gotto AM: Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: Results of AFCAPS/TexCAPS. Air force/Texas coronary atherosclerosis prevention study. JAMA 1998;279:1615–1622.
  25. Colhoun HM, Betteridge DJ, Durrington PN, Hitman GA, Neil AW, Livingstone SJ, Thomason MJ, Mackness MI, Charlton-Menys V, Fuller JH: Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the collaborative atorvastatin diabetes study (CARDS): Multicentre randomised placebo-controlled trial. Lancet 2004;364:685–696.
  26. Group HPSC: MRC/BHF Heart Protection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals. Lancet 2002;360:7–22.
  27. Shepherd J, Blauw GJ, Murphy MB, Bollen ELEM, Buckley BM, Cobbe SM, Ford I, Gaw A, Hyland M, Jukema JW, Kamper AM, Macfarlane PW, Meinders AE, Norrie J, Packard CJ, Perry IJ, Stott DJ, Sweeney BJ, Twomey C, Westendorp RGJ: Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet 2002;360:1623–1630.
  28. Sacks F, Pfeffer M, Moye L, Rouleau J, Rutherford J, Cole T, Brown L, Warnica J, Arnold J, Wun C, Davis B, Braunwald E, the CARE Investigators: The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996;335:1001–1009.
  29. The Lipid Study Group: Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998;339:1349–1357.
  30. Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, Zeiher A, Chaitman BR, Leslie S, Stern D: Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: The MIRACL study: A randomized controlled trial. JAMA 2001;285:1711–1718.
  31. de Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KAA, White HD, Rouleau JL, Pedersen TR, Gardner LH, Mukherjee R, Ramsey KE, Palmisano J, Bilheimer DW, Pfeffer MA, Califf RM, Braunwald E: Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndrome. JAMA 2004;292:1307–1316.


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