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Atorvastatin: an effective lipid-modifying agent in familial hypercholesterolemia
A D Marais1, J C Firth, M E Bateman
1Department of Medicine, University of Cape Town Medical School, South Africa. dmarais@uctgsh1.uCT.ac.za
Arteriosclerosis, Thrombosis, and Vascular Biology
|August 1, 1997
Summary
Atorvastatin effectively lowers LDL cholesterol in familial hypercholesterolemia (FH) patients. This HMG-CoA reductase inhibitor also improves HDL cholesterol and triglyceride levels, demonstrating safety and efficacy.
Area of Science:
- Cardiology
- Pharmacology
- Biochemistry
Background:
- Familial hypercholesterolemia (FH) significantly elevates ischemic heart disease risk.
- Hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitors are primary treatments for FH.
Purpose of the Study:
- To evaluate the efficacy and safety of atorvastatin, a novel HMG-CoA reductase inhibitor, in patients with proven FH.
Main Methods:
- An open-label study involving 22 FH subjects after a 4-week placebo phase.
- Subjects were randomized to receive either 80 mg atorvastatin nocturnally or 40 mg twice daily for 6 weeks.
Main Results:
- Atorvastatin significantly reduced LDL cholesterol by 57% (P < .001) and total cholesterol (P < .001).
- HDL cholesterol increased by 25% (P < .001), and triglycerides decreased by 34% (P < .01).
- Apolipoprotein B decreased by 42%, with transient transaminase elevations in three subjects.
Conclusions:
- Atorvastatin is a potent and safe lipid-modifying agent for heterozygous FH.
- It effectively reduces LDL cholesterol and positively impacts HDL cholesterol and triglyceride levels.
- Atorvastatin may serve as a sufficient monotherapy for many FH patients.