Prevalence of gallstones in hyperlipidemia and incidence during treatment with clofibrate and/or cholestyramine.

The present study provides no evidence that the prevalence of gallstones is increased in patients with hyperlipidemia. During the first year of treatment with clofibrate, the incidence of new gallstones appears to increase 8-fold. Cholestyramine, in doses of 16 g per day, does not seem to increase the incidence of stones, either when given alone or with clofibrate. Further studies on the cumulative risk of clofibrate and the long-term effect of clofibrate on biliary lipid composition are necessary to adequately define the risk/benefit ratio of this medication--with or without bile acid sequestrants. It is highly desirable to ascertain whether the concurrent administration of agents such as chenodeoxycholic or ursodeoxycholic acids could beneficially affect bile lipid composition and hence protect against gallstone formation during the initial period of clofibrate treatment.