Comparative Efficacy and Safety of Low-Dose Pitavastatin Versus Atorvastatin in Patients with Hypercholesterolemia

Sansanayudh, Nakarin; Wongwiwatthananukit, Supakit; Putwai, Pawat; Dhumma-Upakorn, Rawadee

doi:10.1345/aph.1m522

Cited by 21 publications

(28 citation statements)

References 36 publications

(23 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although a growing body of evidence demonstrates the efficacy and safety of atorvastatin in Asian populations of both East Asian31, 32, 33, 34, 35, 36, 37 and South Asian34, 38, 39, 40, 41, 42, 43, 44 origin, many of these previous studies evaluated the safety profile of atorvastatin doses up to 20‐mg over relatively short study durations (6–12 weeks) 31, 33, 35, 36, 41, 42, 43. This current analysis has extended these observations to atorvastatin doses up to 80‐mg and provides strong evidence to support the safety of conventional doses of atorvastatin (10–40‐mg daily) in Asian patients over the short‐ and longer‐term (up to 4.9 years) for intensive lipid lowering.…”

Section: Discussionmentioning

confidence: 99%

Safety of atorvastatin in Asian patients within clinical trials

Chan

Kong

Bao

et al. 2016

Cardiovascular Therapeutics

View full text Add to dashboard Cite

SummaryIntroductionData on statin safety in Asian patients are limited compared with evidence from Western populations.AimThis study assessed atorvastatin safety among Asian patients enrolled in 58 randomized clinical trials.MethodsData from 52 short‐term trials (median exposure 4–72 weeks) and six long‐term cardiovascular outcomes trials (median exposure 3.1–4.9 years) conducted across the atorvastatin 10–80‐mg dose range were analyzed retrospectively to assess the incidence of safety endpoints.ResultsA total of 77 952 patients were identified (49 974 received atorvastatin), among whom 3191 were Asian (2519 received atorvastatin). In the short‐term trials, the incidence of all‐causality adverse events (AEs) and serious AEs (SAEs) in Asian patients treated with atorvastatin was similar to or lower than that observed with other statins or placebo, and discontinuations due to treatment‐related AEs/SAEs were infrequent (2.0% across all doses). These observations were confirmed in the long‐term trials. Treatment‐related SAEs were rare (n = 4) among Asian patients receiving atorvastatin. No cases of rhabdomyolysis were observed in atorvastatin‐treated Asian patients, and the incidence of myalgia was 1.8% in the short‐term studies and 6.7% in the long‐term trials. Elevations (>3× the upper limit of normal) in liver transaminases were observed in ~2% of Asian patients receiving atorvastatin; renal AEs occurred in <2%.ConclusionThe incidence of AEs/SAEs with atorvastatin 10–40‐mg in patients of Asian origin was low and comparable to placebo. Further evaluation of atorvastatin 80‐mg is required owing to the limited number of Asian patients (n = 281; 11.2%) who received this dose.

show abstract

Section: Discussionmentioning

confidence: 99%

Safety of atorvastatin in Asian patients within clinical trials

Chan

Kong

Bao

et al. 2016

Cardiovascular Therapeutics

View full text Add to dashboard Cite

show abstract

“…One published study compared the efficacy and safety of low-dose pitavastatin 1 mg versus atorvastatin 10 mg in patients with hypercholesterolemia. 18 Pitavastatin did not effectively lower LDL-C and TC levels as well as atorvastatin. However, the number of patients attaining their LDL goals was comparable to the number of patients using atorvastatin.…”

Section: Dosage Administration and Costmentioning

confidence: 92%

“…The monthly cost per percent LDL reduction in the pitavastatin group ($0.77) was approximately 50% lower than the cost in the atorvastatin group ($1.56). 18 …”

Section: Dosage Administration and Costmentioning

confidence: 99%

Pitavastatin

Ahmad

Cheng-Lai²

2010

Cardiology in Review

View full text Add to dashboard Cite

Because of their good tolerability and their positive effect on lipid parameters and clinical outcomes, 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) have become the drugs of first choice for the management of dyslipidemia. Pitavastatin is the newest member in the statin family and received Food and Drug Administration approval for oral use in August 2009. Compared to other statins such as atorvastatin, simvastatin and pravastatin at specific doses, pitavastatin dosed at 1 to 4 mg daily showed similar efficacy in lowering low-density lipoprotein cholesterol (LDL-C) and altering other lipid parameters according to a number of studies. In addition, pitavastatin demonstrated cholesterol-lowering efficacy in special populations such as the elderly, patients with diabetes, and patients with higher cardiovascular risk. Because pitavastatin is minimally metabolized by the cytochrome P-450 isoenzymes, it is associated with a lower frequency of drug-drug interactions, and this may be a desirable characteristic of pitavastatin. Beneficial effects, such as reductions of coronary plaque volume and fibrofatty composition, have also been observed with pitavastatin. Thus far, the safety profile of pitavastatin is favorable and appears to be similar to those of other statins. Given its encouraging pharmacokinetic and pharmacodynamic characteristics, pitavastatin is likely to be a good alternative to other more established statins. The pharmacologic and pharmacokinetic properties of pitavastatin are reviewed in this article.

show abstract

“…Thus, the results from the above-described noncomparative studies cannot be consistently applied to these populations. [48][49][50][51][52][53] Each comparison will be discussed in brief below.…”

mentioning

confidence: 99%

“…A number of published studies have evaluated the comparative efficacy of pitavastatin with other commercially available statins on lipid parameters(Table 2) [46][47][48][49][50][51][52][53]. One trial each evaluated pravastatin46 and simvastatin 47 as the additional 8 weeks.…”

mentioning

confidence: 99%

Pitavastatin: a New 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitor for the treatment of hyperlipidemia

Baker

Datta

2010

Adv Therapy

View full text Add to dashboard Cite

Statins have proven beneficial for reducing both primary and secondary events in patients with coronary heart disease. Tight control of serum lipid parameters in these patients is recommended by the most recent clinical guidelines. Although numerous lipid-lowering treatments are available, only a small percentage of eligible patients receive therapy and fewer achieve their lipid-lowering goals. Thus it is clear that new treatment strategies to manage patients with lipid abnormalities are warranted. Pitavastatin (Lival; Kowa Pharmaceuticals America, Montgomery, AL, USA) has been recently approved for the treatment of hypercholesterolemia and combined dyslipidemia. Pitavastatin 1-4 mg/day has shown similar low-density lipoprotein-reducing activity to other commercially available statins, including simvastatin and atorvastatin. Adverse events occurred at similar rates to other statins in clinical trials with favorable effects seen in patients with dyslipidemia and metabolic syndrome. Pharmacokinetic drug-drug interactions are minimized due to the lack of significant metabolism of pitavastatin by the cytochrome P450 enzyme system, although some drugs affect its uptake into hepatocytes and should be avoided. In addition to its higher acquisition cost, pitavastatin has not been shown to improve clinical outcomes in high-risk patient populations and thus may not be the agent of choice in many patients at this time in lieu of cheaper, clinically proven alternatives.

show abstract

Comparative Efficacy and Safety of Low-Dose Pitavastatin Versus Atorvastatin in Patients with Hypercholesterolemia

Cited by 21 publications

References 36 publications

Safety of atorvastatin in Asian patients within clinical trials

Safety of atorvastatin in Asian patients within clinical trials

Pitavastatin

Pitavastatin: a New 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitor for the treatment of hyperlipidemia

Contact Info

Product

Resources

About