Dietary Intake during 56 Weeks of a Low-Fat Diet for Lomitapide Treatment in Japanese Patients with Homozygous Familial Hypercholesterolemia

• Published in: Journal of Atherosclerosis and Thrombosis Vol. 26; no. 1; pp. 72 - 83
• Main Authors: Noriko Kameyama, Chizuko Maruyama, Fuyuha Kitagawa, Kazunobu Nishii, Kaori Uenomachi, Yayoi Katayama, Hiromi Koga, Naoko Chikamoto, Yuko Kuwata, Junko Torigoe, Masako Arimoto, Toshiaki Tokumaru, Katsunori Ikewaki, Atsushi Nohara, Yoshihiko Otsubo, Koji Yanagi, Masayuki Yoshida, Mariko Harada-Shiba
• Format: Journal Article
• Language: Japanese
• Published: Japan Atherosclerosis Society 2019
• ISSN: 1340-3478; 1880-3873

[Aim] : Lomitapide is an oral inhibitor of the microsomal triglyceride transfer protein used to treat homozygous familial hypercholesterolemia (HoFH) ; patients require a low-fat diet to minimize gastrointestinal adverse effects and dietary supplements to prevent nutrient deficiencies. We investigated the diet and nutritional status during lomitapide treatment. [Methods] : Japanese patients with HoFH, who were in a phase 3 trial of lomitapide, were instructed to start low-fat diets with supplements of vitamin E and essential fatty acids 6 weeks before starting lomitapide treatment. Dietary education was conducted by registered dietitians 16 times during the study period, which included a pre-treatment run-in phase (Weeks - 6-0), a lomitapide treatment efficacy phase (Weeks 0-26) and a safety phase (Weeks 26-56). Two-day dietary records were collected at each dietary counseling session. Anthropometric and biochemical parameters were measured at Weeks 0, 26 and 56. [Results] : Eight patients completed the 56 weeks of lomitapide treatment. Their median energy intakes derived from lipids were 19.2% and 17.9% during the efficacy and safety phases, respectively. "Fats and oils" intakes, and "Fatty meat and poultry" intakes in two patients, were successfully reduced to achieve low-fat diets. Although intakes of energy, fatty acids and fat-soluble vitamins did not differ significantly among phases, body weight, serum fatty acid levels and vitamin E concentrations were decreased at Week 26 as compared with Week 0. [Conclusion] : HoFH patients can adhere to low-fat diets with ongoing dietary counseling. Instructions about intakes of energy, fatty acids and fat-soluble vitamins, as well as periodic evaluations of nutritional status, are necessary.