Efficacy of Atorvastatin Compared With Simvastatin in Patients With Hypercholesterolemia

Farnier, Michel; Portal, Jean-Jacques; Maigret, P

doi:10.1177/107424840000500104

Cited by 30 publications

(15 citation statements)

References 11 publications

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“…The LDL-C and TG reductions by atorvastatin and simvastatin observed in the present analysis were typical of what has been reported by others. [20][21][22] Atorvastatin produced slightly greater reductions in LDL-C (Ϫ37 to Ϫ54% for atorvastatin vs. Ϫ35 to Ϫ49% for simvastatin) and TG (Ϫ22 to Ϫ31% for atorvastatin vs. Ϫ22 to Ϫ26% for simvastatin). However, the overall pattern of response (dose-dependent reductions) was the same for both drugs and was maintained across all of the subgroups examined.…”

Section: Discussionmentioning

confidence: 99%

Differential effects of simvastatin and atorvastatin on high‐density lipoprotein cholesterol and apolipoprotein A‐I are consistent across hypercholesterolemic patient subgroups

Davidson

Ose

Fröhlich

et al. 2003

Clinical Cardiology

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SummaryBackground: In addition to lowering plasma levels of lowdensity lipoprotein cholesterol (LDL-C), statins also raise high-density lipoprotein cholesterol (HDL-C).Hypothesis: Recent studies have shown that treatment with simvastatin results in larger increases in HDL-C than those seen with atorvastatin. The results of three clinical studies are analyzed, comparing the effects of simvastatin and atorvastatin on HDL-C and apolipoprotein A-I (apo A-I) in the total cohort and in several subgroups of hypercholesterolemic patients. The three studies were all multicenter, randomized clinical trials that included simvastatin (20-80 mg) and atorvastatin (10-80 mg) treatment arms. The subgroup analyses performed were gender; age (< 65 and ≥ 65 years); baseline HDL-C (male: <40 or ≥40 mg/dl; female: < 45 or ≥45 mg/dl), baseline LDL-C (< 160 or ≥ 160 mg/dl), and baseline triglycerides (< 200 or ≥ 200 mg/dl).Results: Both drugs produced similar increases in HDL-C levels at low doses; however, at higher drug doses (40 and 80 mg), HDL-C showed a significantly greater increase with simvastatin than with atorvastatin (p < 0.05 to < 0.001). Therefore, while HDL-C remained consistently elevated across all doses of simvastatin, there appeared to be a pattern of decreasing

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Section: Discussionmentioning

confidence: 99%

Differential effects of simvastatin and atorvastatin on high‐density lipoprotein cholesterol and apolipoprotein A‐I are consistent across hypercholesterolemic patient subgroups

Davidson

Ose

Fröhlich

et al. 2003

Clinical Cardiology

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“…A number of RCTs have directly compared statins using surrogate end points, such as lipid reduction, [21][22][23] markers of hemostasis and inflammation [24][25][26] or reduction in number of atherotic plaques. 27 However, the extent to which these results can be extrapolated to clinically relevant outcomes remains to be established.…”

mentioning

confidence: 99%

Effectiveness of statins for secondary prevention in elderly patients after acute myocardial infarction: an evaluation of class effect

Zhou

Rahme²,

Abrahamowicz³

et al. 2005

Canadian Medical Association Journal

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ResearchRecherche R andomized controlled trials (RCTs) have shown that the use of statins after acute myocardial infarction (AMI) are effective in reducing the incidence of both fatal and nonfatal cardiovascular events. [1][2][3][4][5][6][7][8] Although these trials have significantly influenced post-AMI treatment, [9][10][11][12] it remains unclear whether all statins are equally effective in preventing recurrent AMI and death. Drugs in the same class are generally thought to be therapeutically equivalent because of similar mechanisms of action (class effect). [13][14][15] However, in the absence of comparative data, this assumption requires evaluation. Statins differ in multiple characteristics, including liver and renal metabolism, half-life, effect on other serum lipid components, bioavailability and potency. [16][17][18][19] These differences could potentially influence the extent to which the drugs are beneficial. Despite limited evidence in support of a differential benefit of statins for secondary prevention, preferential prescribing already occurs in practice and cannot be fully explained by the existing evidence or guidelines. 20 Comparative data of statins are thus required to inform health care decision-making.A number of RCTs have directly compared statins using surrogate end points, such as lipid reduction, 21-23 markers of hemostasis and inflammation [24][25][26] or reduction in number of atherotic plaques. 27 However, the extent to which these results can be extrapolated to clinically relevant outcomes remains to be established. The newly released PROVE IT-TIMI 22 trial 28 was the first trial to compare 2 statins for cardiovascular prevention. The study showed that atorvastatin used at a maximal dose of 80 mg (intensive therapy) was better than pravastatin at a dose of 40 mg (standard therapy) in decreasing the incidence of cardiovascular events and procedures. The study was, however, conducted to show the benefit associated with increased treatment intensity. It did not compare the drugs by milligramequivalent doses or by cholesterol-lowering equivalent doses. Moreover, no difference was detected when death alone or the combined outcome of death or AMI was evaluated. Other than the PROVE IT-TIMI 22 trial, few data are currently available from RCTs that compare statins for cardiovascular prevention. 29 We conducted a population-based study to examine the relative effectiveness of different statins for long-term secondary prevention after AMI. We used retrospective cohorts of elderly patients prescribed statins after AMI in 3 provinces. Five statins were studied: atorvastatin, pravastatin, simvastatin, lovastatin and fluvastatin. The newest statin, rosuvastatin, was not available during the study period and was not considered in this study. acute myocardial infarction (AMI). However, it is unclear whether different statins exert a similar effect in reducing the incidence of recurrent AMI and death when used in clinical practice. Methods: We conducted a retrospective cohort study (1997)(1998)(1999)...

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“…Direct comparisons between atorvastatin, the most frequently prescribed statin, and simvastatin have generated a spectrum of results with regards to the effectiveness of the switch (15)(16)(17)(18)(19)(20)(21)(22)(23). An important factor in all of these comparative trials appears to be the use of equivalent doses for comparison between the individual agents.…”

Section: Discussionmentioning

confidence: 99%

Clinical and economic outcomes in patients switched to simvastatin in a community-based family medicine practice

Willey

Reinhold

Willey

et al. 2010

International Journal of Clinical Practice

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Efficacy of Atorvastatin Compared With Simvastatin in Patients With Hypercholesterolemia

Abstract: In primary hypercholesterolemia, atorvastatin 10 mg was more effective and nonequivalent to simvastatin 20 mg and significantly more effective than simvastatin 10 mg for reducing LDL cholesterol levels.

Cited by 30 publications

References 11 publications

Differential effects of simvastatin and atorvastatin on high‐density lipoprotein cholesterol and apolipoprotein A‐I are consistent across hypercholesterolemic patient subgroups

Differential effects of simvastatin and atorvastatin on high‐density lipoprotein cholesterol and apolipoprotein A‐I are consistent across hypercholesterolemic patient subgroups

Effectiveness of statins for secondary prevention in elderly patients after acute myocardial infarction: an evaluation of class effect

Clinical and economic outcomes in patients switched to simvastatin in a community-based family medicine practice

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