Comparison between low-dose simvastatin and cholestyramine in moderately severe hypercholesterolemia.

In a 6-week multicenter study, we compared the efficacy and tolerance of a treatment with 10 mg of simvastatin, a new inhibitor of the HMG-CoA reductase to that of 12 g cholestyramine in 145 patients whose total cholesterol remained between 250 and 350 mg/dl after 4 weeks of a standard lipid-lowering diet. The decrease in total cholesterol reached 21% in the simvastatin group and 16% in the cholestyramine group (p less than 0.01) while the LDL-cholesterol decreased respectively by 30% and 25%. HDL cholesterol increased by 11% in the simvastatin group and by 7% in the cholestyramine group. The ratios of total to HDL cholesterol and LDL to HDL cholesterol decreased by 28.1% and 35.8% respectively with simvastatin and by only 19.5% and 27.9% respectively with cholestyramine. Triglycerides decreased by 5.8% with simvastatin and increased by 8.5% with cholestyramine. Significantly less adverse experiences were observed with simvastatin than with cholestyramine. Simvastatin at the dosage of 10 mg appeared to be at least as efficient as 12 g of cholestyramine and generally better tolerated.