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A Double-blind, Crossover Study

David A. Leaf, MD; William E. Connor, MD; D. Roger Illingworth, MD, PhD; Sandra P. Bacon, RN; Gary Sexton, PhD

JAMA. 1989;262(22):3154-3160.

Abstract
Thirteen patients with phenotypic type V hyperlipidemia were treated with either gemfibrozil (Lopid) or a placebo in a randomized, double-blind, crossover study for two 8-week periods. A 4-week baseline period of a low-fat diet preceded the study and served as a dietary control period. A 4-week washout period followed the two 8-week periods. Compared with the placebo phase, gemfibrozil produced a significant reduction in the concentrations of total plasma triglycerides (21.03 vs 5.50 mmol/L) and very low—density lipoprotein triglycerides (14.40 vs 4.59 mmol/L) as well as in total plasma cholesterol levels (10.88 vs 5.62 mmol/L) and very low—density lipoprotein cholesterol (6.66 vs 2.15 mmol/L). Chylomicronemia was virtually abolished by the drug treatment. As expected in treated patients with type V hyperlipidemia, concentrations of low-density lipoprotein cholesterol rose after therapy with gemfibrozil (3.08 mmol/L) as compared with placebo (1.84 mmol/L); high-density lipoprotein cholesterol also increased (0.85 mmol/L after therapy with gemfibrozil, 0.62 mmol/L after placebo). The previously very low values for both of these lipoproteins increased at the same time that the total plasma cholesterol value decreased. We conclude that gemfibrozil is a well-tolerated and effective hypolipidemic agent for the treatment of patients with severe hypertriglyceridemia when used in conjunction with a low-fat diet.

(JAMA. 1989;262:3154-3160)

Author Affiliations
From the Division of Endocrinology/Metabolism/Clinical Nutrition, Department of Medicine, The Oregon Health Sciences University, Portland. Dr Leaf is currently with the Division of Nutrition, Department of Medicine, School of Medicine, University of California at Los Angeles.

Footnotes
Reprint requests to the Department of Medicine— L465, The Oregon Health Sciences University, Portland, OR 97201 (Dr Connor).

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ABSTRACT  

Primary Hypertriglyceridemia With Borderline High Cholesterol and Elevated Apolipoprotein B Concentrations: Comparison of Gemfibrozil vs Lovastatin Therapy
Vega and Grundy
JAMA 1990;264:2759-2763.
ABSTRACT  

Treatment Choices for Hypertriglyceridemia
Connor
JAMA 1990;264:2797-2798.
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