Gemfibrozil in the Treatment of Dyslipidaemia A 5‐year follow‐up study

The efficacy and safety of gemfibrozil in treating dyslipidaemias was investigated in a 5‐year follow‐up study of 254 patients with primary dyslipidaemias. Most were middle‐aged males of type IIA or IIB. A significant correction of serum lipid level was seen in about 90% of dyslipidaemias, irrespective of the type. It was not possible to find a clear cause for non‐responsiveness, although cirrhosis of the liver was suggested in some cases. Overall, gemfibrozil decreased serum total cholesterol by 16% LDL cholesterol by 23% and the triglyceride level by 40%; HDL cholesterol rose by 23% and HDL cholesterol as percentage of total cholesterol from 14.3% to 20.8% to approach the value of matched controls in the population without dyslipidaemia (24.2%). Side‐effects were few. Among the treated subjects the observed number of myocardial infarctions was much less (4 vs 14) than expected. This by no means proves that gemfibrozil will prevent myocardial infarction, but is evidence to support that raising HDL and lowering LDL may give clinical benefit in the prevention of coronary heart disease. A more substantial primary prevention study in a population of patients at high risk, i.e. middle‐aged males with dyslipidaemia, is warranted.