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Long term efficacy and safety of atorvastatin in the treatment of severe type III and combined dyslipidaemia
  1. M van Dam1,
  2. M Zwart1,
  3. F de Beer2,
  4. A H M Smelt2,
  5. M H Prins1,
  6. M D Trip1,
  7. L M Havekes2,
  8. P J Lansberg1,
  9. J J P Kastelein1
  1. 1Department of Vascular Medicine, Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, Netherlands
  2. 2Department of Internal Medicine, Leiden University Medical Centre, 2300 RC, Leiden, Netherlands
  1. Correspondence to:
    Dr JJP Kastelein, Department of Vascular Medicine, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, Netherlands;


Background: Fibric acid derivatives and HMG-CoA reductase inhibitors are effective in combination for treating patients with familial dysbetalipoproteinaemia and severe combined dyslipidaemia, but combination therapy affects compliance and increases the risk of side effects.

Aim: To evaluate the efficacy and safety of monotherapy with atorvastatin, an HMG-CoA reductase inhibitor with superior efficacy in lowering low density lipoprotein cholesterol and triglyceride concentrations, in patients with dysbetalipoproteinaemia and severe combined dyslipidaemia.

Methods: Atorvastatin was tested as single drug treatment in 36 patients with familial dysbetalipoproteinaemia and 23 patients with severe combined dyslipidaemia.

Results: After 40 weeks of 40 mg atorvastatin treatment decreases in total cholesterol, triglycerides, and apolipoprotein B of 40%, 43%, and 41%, respectively, were observed in the combined dyslipidaemia group, and of 46%, 40%, and 43% in the dysbetalipoproteinaemic patients. Target concentrations of total cholesterol (< 5 mmol/l) were reached by 63% of the patients, and target concentrations of triglycerides (< 3.0 mmol/l) by 66%. Treatment with atorvastatin was well tolerated and no serious side effects were reported.

Conclusions: Atorvastatin is very effective as monotherapy in the treatment of familial dysbetalipoproteinaemia and severe combined dyslipidaemia.

  • familial dysbetalipoproteinaemia
  • apolipoprotein E
  • atorvastatin
  • severe combined dyslipidaemia
  • apo E, apolipoprotein E
  • C, cholesterol
  • FD, familial dysbetalipoproteinaemia
  • HDL, high density lipoprotein
  • IDL, intermediate density lipoprotein (VLDL remnants)
  • LDL, low density lipoprotein
  • TG, triglyceride
  • VLDL, very low density lipoprotein

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