Fenofibrate and colestipol: effects on serum and lipoprotein lipids and apolipoproteins in familial hypercholesterolaemia.

Effects on serum lipoproteins were studied in ten patients with familial hypercholesterolaemia (FH) during consecutive eight-week treatment periods with fenofibrate 0.3 g/day, fenofibrate plus colestipol, 15 g/day, and fenofibrate 0.25 g/day plus colestipol. VLDL, LDL, HDL, HDL2, and HDL3 were isolated by ultracentrifugation and precipitation. Lipids and apolipoproteins A-I and B were determined by enzymatic and immunonephelometric techniques, respectively. Administration of fenofibrate alone resulted in decreases in VLDL and LDL cholesterol (-48% and -18%) and in serum apolipoprotein B (-10%), but in increases in HDL, HDL2, and HDL3 (+25%, +26%, and +24%), and in serum apolipoprotein A-I (+6%). Addition of colestipol produced a further reduction in LDL cholesterol (-31%) and in serum apolipoprotein B (-19%). The effects were maintained with less fenofibrate. In FH, an acceptable therapy combines the favourable effects of sufficient lowering of LDL and of a rise in HDL.