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Circulation, Vol 70, 1004-1011, Copyright © 1984 by American Heart Association

ARTICLES

Normalization of plasma lipoprotein concentrations in patients with type II hyperlipoproteinemia by combined use of neomycin and niacin

JM Hoeg, MB Maher, E Bou, LA Zech, KR Bailey, RE Gregg, DL Sprecher, JK Susser, AM Pikus and HB Brewer Jr

The oral administration of neomycin or niacin as single-drug therapy can significantly lower total and low-density lipoprotein cholesterol concentrations in patients with type II hyperlipoproteinemia. However, in the majority of patients treated with one of these drugs as sole therapy plasma lipid and lipoprotein concentrations do not normalize. The effect of combined neomycin (2 g/day) and niacin (3 g/day) treatment on the plasma lipoprotein concentrations was determined in 25 type II hyperlipoproteinemic patients in a double-blind, randomized, placebo-controlled, crossover clinical trial. Treatment with neomycin was well tolerated by all 25 study patients and significantly reduced total and low-density lipoprotein cholesterol concentrations by 23% and 29%, respectively (p less than .05). In contrast to the well-tolerated neomycin regimen, 11 patients (44%) were unable to continue niacin treatment because of adverse side effects. In the 14 patients treated with both neomycin and niacin, niacin further lowered the concentrations of total and low-density lipoprotein cholesterol by 18% and 25%, respectively, and increased high-density lipoprotein cholesterol by 32% (p less than .05) compared with that in the patients receiving neomycin plus niacin placebo. Compared with diet-only therapy, combined treatment with neomycin plus niacin reduced the total plasma cholesterol concentration by 36%, low-density lipoprotein cholesterol by 45%, and the low-density lipoprotein/high-density lipoprotein ratio by 46% and it increased plasma high-density lipoprotein concentrations by 24% (p less than .001). During the study, 80% of all the study patients and 92% of the patients who complied with the combined regimen normalized their total and low-density lipoprotein concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)

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