Atorvastatin compared with simvastatin-based therapies in the management of severe familial hyperlipidaemias

Wierzbicki, A S; Lumb, P J; Semra, Y; Chik, G; Christ, E R; Crook, M A (1999). Atorvastatin compared with simvastatin-based therapies in the management of severe familial hyperlipidaemias. QJM - an international journal of medicine, 92(7), pp. 387-94. Oxford: Oxford University Press 10.1093/qjmed/92.7.387

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Endocrinology, Diabetology and Clinical Nutrition

UniBE Contributor:

Christ, Emanuel

ISSN:

1460-2725

Publisher:

Oxford University Press

Language:

English

Submitter:

Factscience Import

Date Deposited:

04 Oct 2013 15:23

Last Modified:

17 Mar 2015 22:49

Publisher DOI:

10.1093/qjmed/92.7.387

PubMed ID:

10627888

Web of Science ID:

000081627600005

URI:

https://boris.unibe.ch/id/eprint/37232 (FactScience: 207244)

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