Lovastatin and gemfibrozil in the treatment of type 2a and type 2b hyperlipoproteinemia.

Subanalyses of previous multicenter studies comparing lovastatin and gemfibrozil were carried out to evaluate the merits of these agents in patients with different serum lipid phenotypes (type 2a and 2b hyperlipoproteinemia). Regardless of phenotype, lovastatin was more effective in lowering LDL-cholesterol, while gemfibrozil had a greater triglyceride-lowering and HDL-cholesterol-increasing effect. Patients with type 2a phenotype benefited (in terms of serum lipid pattern) more from lovastatin. In type 2b hyperlipoproteinemia, more patients taking lovastatin than gemfibrozil reached both treatment goals defined by the European Atherosclerosis Society, (LDL-cholesterol 4.0 mmol/l and triglycerides 2.3 mmol/l). In many patients these goals could not be met suggesting that multiple drug therapy may be indicated in part of the patients with type 2b hyperlipoproteinemia.