Assessment the Optimum Efficacy and Neurologic Side Effect(S) of Antihyperlipidemic Drug Regimens in Dyslipidemic Adult Patients

Aim: To assess the optimum efficacy and neurological side effect(s) of antihyperlipidemic drug regimens in dyslipidemic adult patients. Material and Method: Fotry-two male, eighty-seven female; totally 129 dyslipidemic patients, 37 to 77 years of age who admitted to neurology and cardiology out-patient clinics were eligible for our study. All of the patients were recommended to reach an ideal body weight and to maintain a standard low-lipid diet. Patients were divided into 5 subgroups and were assigned to receive commonly used antihyperlipidemic agents; low-dose atorvastatin (10 mg), pravastatin (10 mg), simvastatin (10 mg), fenofibrate (200 mg) and a combination of fenofibrate and atorvastatin regimen. Neurological examination was evaluated besides fasting plasma lipid profile and muscle enzyme levels at 0, 3, 6 and 12-month intervals. Electroneuromyography (ENMG) was performed in patients having neurological complaint(s), finding(s) and/or elevated muscle enzyme levels after drug administration. Results: According to ATP III criteria, in the second 6-month period, fenofibrate effectively improved the triglyceride profile in patients with high and borderline plasma lipid levels versus pravastatin therapy. In the first 3-month period, atorvastatin significanty improved LDL-C levels versus fenofibrate. In the first 6-month period, pravastatin caused a marked elevation of creatinine kinase levels versus atorvastatin. Among all the drugs, no other differences were observed either on lipid or on side effect profiles. No pathological findings were observed in patients who underwent ENMG. Conclusion: For the first year, low-dose antihyperlidemic agents have mostly similar efficacy profiles. Encountered side effects are; myalgia and elevated serum creatinine phosphokinase (CPK) levels at a range of 4-68 %. CPK elevations did not exceed to 3 to 10 times as reported in the literature with any of the drugs. In spite of myopathic changes in ENMG, myalgia was commonly reported. In conclusion we suggest that, patients at hig-risk, represent a suitable group for prolonged statin treatment with regular clinical follow-up.