Atorvastatin compared with simvastatin-based therapies in the management of severe familial hyperlipidaemias
| Autor: | Y.K. Semra, Peter J. Lumb, Emanuel Christ, G Chik, Martin A. Crook, Anthony S. Wierzbicki |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
Male
Simvastatin medicine.medical_specialty medicine.medical_treatment Atorvastatin Hyperlipidemia Familial Combined Urology Drug Administration Schedule Rhabdomyolysis chemistry.chemical_compound Internal medicine Hyperlipidemia medicine Humans Pyrroles Prospective Studies cardiovascular diseases Triglycerides Chemotherapy Fenofibrate Cholesterol business.industry Anticholesteremic Agents Cholesterol HDL Fibrinogen nutritional and metabolic diseases Cholesterol LDL General Medicine Middle Aged medicine.disease Hydroxymethylglutaryl-CoA reductase Endocrinology chemistry Heptanoic Acids Female lipids (amino acids peptides and proteins) business medicine.drug |
| Zdroj: | QJM. 92:387-394 |
| ISSN: | 1460-2393 |
| DOI: | 10.1093/qjmed/92.7.387 |
| Popis: | We compared atorvastatin with simvastatin-based therapies in a prospective observational study of 201 patients with severe hyperlipidaemia. Atorvastatin 10 mg therapy was substituted for simvastatin 20 mg, 20 mg for 40 mg, 40 mg for simvastatin 40 mg plus resin, and 80 mg for simvastatin-fibrate-resin therapy. Lipid and safety profiles were assessed. Atorvastatin reduced total cholesterol by 31 +/- 11-40 +/- 14% vs. 25 +/- 12-31 +/- 11%; LDL by 38 +/- 16-45 +/- 18% vs. 31 +/- 18-39 +/- 18% and geometric mean triglycerides by 29.3-37.3% vs. 16.6-24.8%, but reduced HDL 11% +/- 47% at 80 mg compared with a 16% +/- 34% increase with simvastatin-based therapy. Target LDL < 3.5 mmol/l was achieved more often with atorvastatin (63% vs. 50%; p < 0.001). Atorvastatin increased geometric mean fibrinogen by 12-20% vs. a 0-6% fall with simvastatin (p << 0.001). Side effects were noted in 10-36% of patients, including one case of rhabdomyolysis, and 36% discontinued therapy. These data suggest that atorvastatin is more effective than current simvastatin-based therapies in achieving treatment targets in patients with familial hypercholesterolaemia but at the expense of a possible increase in side-effects. This issue needs further study in randomized controlled trials. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|