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Title: Fluvastatin Improves Hyperlipidaemia in Nephrotic Syndrome: Presented at WCN

"Fluvastatin Improves Hyperlipidaemia in Nephrotic Syndrome: Presented at WCN"

By Paula Moyer BERLIN, GERMANY -- June 11, 2003 -- Patients with nephrotic syndrome have lower cholesterol levels after 3 months of treatment with fluvastatin (Lescol), according to findings presented here June 9th at the World Congress of Nephrology. "This finding is good news because we need to reduce hyperlipidaemia in nephrotic syndrome patients who are immunosuppressed," said Mila Ljubomirova, MD, a senior assistant nephrologist at University Hospital Alexandrovska, in Sofia, Bulgaria. "These patients are at risk of cardiovascular disease. Therefore, we need to treat them with a drug like fluvastatin." In patients with nephrotic syndrome, hyperlipidaemia results from increased synthesis and decreased catabolism of lipoproteins. Patients typically have high levels of total cholesterol, triglycerides, low-density lipoproteins (LDL), and very low-density lipoproteins (VLDL), although the high-density lipoproteins (HDL) may be normal. Because of the general efficacy of HMG-CoA reductase inhibitors on hyperlipidaemia and some demonstrated potential in reducing proteinuria, Dr. Ljubomirova and her co-investigators sought to determine the effect of fluvastatin in patients with nephrotic syndrome. They followed 7 women and 12 men, whose average age was 39 years and who had severe nephrotic syndrome, as defined by a glomerular filtration rate (GRF) of over 90 mL/min, as well as severe hyperlipidaemia, consisting of a total cholesterol level exceeding 8.5 mmol/L. Nine patients had membranous glomerulonephritis, 4 had focal segmental glomerulosclerosis, 3 had mesangiocapillary glomerulonephritis, and 3 had lupus nephritis. All patients were treated either with corticosteroids alone or in combination with cytotoxic drugs, depending on the severity of their nephrotic syndrome. The investigators used the patients' 4-hour creatinine clearance to estimate the GFR. Patients received 40 mg daily of fluvastatin for 3 months, after which Dr. Ljubomirova and her investigative team compared patients' total cholesterol, triglycerides, LDL, and HDL to baseline levels. They also examined patients' 24-hour proteinuria at baseline and after 3 months. Patients' total cholesterol averaged 9.33 mmol/L at baseline and 5.91 mmol/L at the study's end, a significant decrease, Dr. Ljubomirova said (P<0.001). Triglyceride levels were also significantly reduced, from an average of 5.92 mmol/L at baseline to 2.74 mmol/L after treatment (P<0.01). LDL averaged 6.35 mmol/L at baseline and 3.57 mmol/L afterward (P<0.001). HDL levels were also lowered, but remained normal in all patients (P=0.01). However, no significant decrease in proteinuria was observed, she said. "We saw a significant reduction of hyperlipidaemia in these patients, even though the nephrotic proteinuria remained," Dr. Ljubomirova said. She added that she and her colleagues would like to see a long-term study that assesses the effect of statins on proteinuria with carefully selected patients who are not taking immunosuppressive therapy. [Study title: Effects Of 3 Months Fluvastatin Treatment On Lipid Metabolism And Proteinuria In Patients With Nephrotic Syndrome. Abstract M197]

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