Long term administration of lovastatin in the treatment of hypercholesterolaemia.

Lovastatin, a competitive inhibitor of the rate limiting enzyme in cholesterol biosynthesis, has been shown to be an effective hypocholesterolaemic agent when given in relatively short term studies to normal human subjects and patients with primary hypercholesterolaemia. The present report reviews the author's experience with lovastatin in the treatment of patients with hypercholesterolaemia (predominantly attributable to heterozygous familial hypercholesterolaemia) over a four year period. Lovastatin has been well tolerated and patients maintained on this drug as a single agent have shown sustained reductions in the plasma concentrations of total and low density lipoprotein cholesterol. The hypocholesterolaemic effects of lovastatin can be potentiated by combination therapy with other currently approved lipid lowering medications including bile acid sequestrants and nicotinic acid. Side effects have been uncommon and no consistent pattern of adverse effects of lovastatin has developed with more prolonged use. Lovastatin and related drugs represent a major advance in the therapy of hypercholesterolaemia.