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Efficacy and safety of atorvastatin compared to pravastatin in patients with hypercholesterolemia
S Bertolini1, G B Bon, L M Campbell
1Ospedali Civili Riuniti, Venice, Italy.
Insights
Atorvastatin significantly reduced LDL-C in hypercholesterolemic patients more effectively than pravastatin. This study confirms atorvastatin
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Clinical Research
Background:
- Plasma lipoproteins, including cholesterol, are key factors in atherosclerosis and coronary heart disease (CHD).
- Hypercholesterolemia requires effective lipid-lowering therapies to mitigate cardiovascular risk.
Purpose of the Study:
- To compare the efficacy and safety of atorvastatin versus pravastatin in managing hypercholesterolemia.
- To assess the ability of atorvastatin to achieve target low-density lipoprotein cholesterol (LDL-C) levels.
Main Methods:
- A 1-year, randomized, multi-center study in six European countries.
- Patients received a 6-week placebo baseline, followed by atorvastatin (10 mg) or pravastatin (20 mg) daily.
- Doses could be doubled if LDL-C remained above 3.4 mmol/l (135 mg/dl).
Main Results:
- Atorvastatin achieved a 35% LDL-C reduction versus 23% for pravastatin (P < 0.05).
- 72% of atorvastatin patients reached the LDL-C target (< 3.4 mmol/l) compared to 26% on pravastatin.
- Atorvastatin also demonstrated superior reductions in total cholesterol, triglycerides, and apo B.
Conclusions:
- Atorvastatin (10/20 mg daily) is more effective than pravastatin (20/40 mg daily) in lowering LDL-C in hypercholesterolemic patients.
- Both treatments exhibited similar safety profiles with no significant laboratory abnormalities.
- Atorvastatin offers a superior therapeutic option for managing hypercholesterolemia.
Abstract:
Plasma cholesterol and other lipoproteins play a significant role in the development of atherosclerosis and subsequent coronary heart disease (CHD). This 1 year study was designed to confirm the efficacy and safety of atorvastatin (Lipitor) compared to pravastatin, a marketed agent for low density lipoprotein cholesterol (LDL-C) reduction in hypercholesterolemic patients. Patients were recruited at 26 centers in six European countries. After a 6 week placebo baseline phase, patients were randomized to receive atorvastatin 10 mg or pravastatin 20 mg daily. The dose could be doubled at week 16, if LDL-C levels remained > or = 3.4 mmol/l (135 mg/dl). Atorvastatin significantly lowered LDL-C from baseline by 35% compared with 23% for pravastatin (P < 0.05). A total of 72% of atorvastatin patients attained the LDL-C target level of < 3.4 mmol/l, compared to 26% of pravastatin patients. Atorvastatin also significantly reduced TC, TG and apo B (P < 0.05). Safety was assessed by recording adverse events and measuring clinical laboratory parameters. The adverse event profile was similar for both treatment groups and neither treatment caused clinically relevant laboratory abnormalities. Atorvastatin 10 and 20 mg once daily is superior to pravastatin 20 and 40 mg once daily in treating patients with hypercholesterolemia.