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Comparison of Gemfibrozil vs Lovastatin Therapy

Gloria Lena Vega, PhD; Scott M. Grundy, MD, PhD

JAMA. 1990;264(21):2759-2763.

Abstract
A common pattern of dyslipidemia is elevated levels of plasma triglyceride, borderline high total cholesterol, reduced high-density lipoprotein, and increased apolipoprotein B. This pattern of dyslipidemia frequently is associated with premature coronary heart disease. Nicotinic acid is the drug of first choice for this pattern. In this study, gemfibrozil and lovastatin were compared for their effects on the overall lipoprotein profile in 13 men with this type of dyslipidemia. Both drugs significantly reduced very-low—density lipoprotein and intermediate-density lipoprotein cholesterol levels, and both modestly raised high-density lipoprotein cholesterol levels. Gemfibrozil therapy, however, failed to reduce total cholesterol or total apolipoprotein B levels, whereas lovastatin therapy lowered levels of total cholesterol by 28%, low-density lipoprotein cholesterol by 33%, and total apolipoprotein B by 32%. Moreover, lovastatin therapy caused greater declines in lipoprotein cholesterol ratios than gemfibrozil therapy. Lovastatin thus seems to have certain advantages over gemfibrozil for treatment of elevated plasma triglyceride levels accompanied by borderline high total cholesterol and raised apolipoprotein B levels; therefore, lovastatin therapy should be considered as one approach for management of this condition.

(JAMA. 1990;264:2759-2763)

Author Affiliations
From the Center for Human Nutrition (Drs Vega and Grundy), the Departments of Clinical Nutrition (Drs Vega and Grundy), Internal Medicine (Dr Grundy), and Biochemistry (Dr Grundy), University of Texas Southwestern Medical Center at Dallas and Veterans Affairs Medical Center, Dallas (Dr Grundy).

Footnotes
Reprint requests to Center for Human Nutrition, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75235-9052 (Dr Grundy).

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