Efficacy of alternate day dosing of atorvastatin

• Authors: Kamran Aghasadeghi , Didar Zare
• Languages of publication: EN

Abstracts

EN

Atorvastatin is a synthetic inhibitor of 3-hydroxy 3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor. It has a longer half life and longer duration of action than that of all other available HMG-CoA inhibitors. We evaluated the efficacy of alternate-day dosing of atorvastatin in comparison with the standard one-daily dose on total cholesterol, low and High-density lipoprotein (LDL and HDL) and triglycerides. This study is a randomized, blinded, and controlled clinical trial. Sixty-six patients with LDL cholesterol of more than 100 mg/dl were enrolled. Baseline fasting lipid profile (total cholesterol, LDL, HDL and triglyceride), liver function tests and creatine kinase were drawn. Patients were randomized to three atorvastatin dose groups. Group I received 10 mg of atorvastatin every day, group II received 20 mg of atorvastatin every day, and group III received 20 mg every other day. After 6 weeks of treatment with atorvastatin, fasting lipid profiles, liver function tests and creatine kinase concentrations were re-taken. Compliance to treatment was assessed at each visit. Of the sixty-six patients enrolled, sixty completed the study. All three regimens significantly reduced total cholesterol and LDL compared to baseline. No statistically significant difference existed between the three groups in regards to total or a percentage decrease in total cholesterol and LDL cholesterol at 6 weeks compared to baseline. All regimens were well tolerated and none of the patients showed significant elevation of liver enzyme or creatine kinase during the course of the study. In conclusions the alternate-day dosing of atorvastatin is an efficacious and safe alternate to daily dosing and yet inexpensive.

Keywords

EN

Atorvastatin; Cholesterol; Dosing; Lipoprotein

• Publisher: De Gruyter Open
• Journal: Open Medicine
• Year: 2008
• Volume: 3
• Issue: 2
• Pages: 163-166

Dates

published

1 - 6 - 2008

online

9 - 4 - 2008

Contributors

author

Kamran Aghasadeghi

• Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran

author

Didar Zare

• Department of Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran

References

• [1] Genest J.J., McNamard J.R., Salem D.N., Schaefer E.J., Prevalence of risk factors in men with premature coronary artery disease, Am. J. Cardiol., 1991, 67, 1185–1189 http://dx.doi.org/10.1016/0002-9149(91)90924-A[Crossref]
• [2] Lacoste L., Lam J.Y.T., Hung J., Letchacovski G., Solymoss C.B., Waters D., Hyperlipidemia and coronary disease correction of the increased thrombogenic potential with cholesterol reduction, Circulation, 1995, 92, 3128–3177
• [3] Castelli M.P., Garrison R.J., Wilson P.W., Abbott R.D., Kalousdian S., Kannel W.B., Incidence of coronary heart disease and lipoprotein cholesterol level. The Framingham study, JAMA, 1986, 256, 2835–2838 http://dx.doi.org/10.1001/jama.256.20.2835[Crossref]
• [4] Grundy S.M., Balady G.J., Criqui M.H., Fletcher G., Greenland P., Hiratzka L.F., et al., Primary prevention of coronary heart disease: guidance from Framingham, Circulation, 1998, 97, 1876–1887
• [5] Corsini A., Bellosta S., Baetta R., Fumagalli R., Paoletti R., Bernini F., New insight into the pharmacodynamic and pharmacokinetic properties of statin, Pharmacol. Ther., 1999, 84, 413–428 http://dx.doi.org/10.1016/S0163-7258(99)00045-5[Crossref]
• [6] Robert W.M., Thomas B.P., Drug therapy for hypercholesterolemia and dyslipidemia. In: Goodmann and Gillmann’s Pharmacologic basis of therapeutics. 10th International Edition 2001.
• [7] Davidson M., McKenny J., Stein E.A., Comparison of one year efficacy and safety of etorvastatin versus lovastatin in primary hypercholesterolemia, Am. J. Cardiol., 1997, 79, 1475–1481 http://dx.doi.org/10.1016/S0002-9149(97)00174-4[Crossref]
• [8] Gibson B.M., Bron N.J., Richens A., Hounslow N.J., Sedman A.J., Whitfield L.R., Effect of age and gender pharmacokinetics of atorvastatin in humans, J. Clin. Pharmacol., 1996, 36, 242–246 [Crossref]
• [9] National cholesterol education program expert panel. Executive summary of third report of the national cholesteroleducation program (NCEP) expert panel on detection, evaluation and treatment of high blood cholesterol in adult, JAMA, 2001, 285, 2486–2497
• [10] Treasure C.B., Klein J.L., Weintraub W.S., Talley J.D., Stillabower M.E., Kosinski A.S., et al., Beneficial effects of cholesterol lowering therapy on coronary endothelium in patients with coronary artery disease, N. Eng. J. Med., 1995, 332, 481–487 http://dx.doi.org/10.1056/NEJM199502233320801[Crossref]
• [11] Brown B.G., Zhao X.Q., Sacco D.E., Lipid lowering and plaque regression. New insights into prevention of plaque disruption and clinical events in coronary disease, Circulation, 1993, 87, 1781–1791
• [12] Corsini A., Pazzucconi F., Arnaboldi L., Pfister P., Fumagalli R., Paoletti R., et al., Direct effect of statins on the vascular wall, J. Cardiovasc. Pharmacol., 1998, 31, 773–778 http://dx.doi.org/10.1097/00005344-199805000-00017[Crossref]
• [13] Tandon V., Bano G., Khajuria V., Parihar A., Gupta S., Pleiotropic effects of statins, Indian J. Pharmacol., 2005, 37, 77–85 http://dx.doi.org/10.4103/0253-7613.15106[Crossref]
• [14] Werba P.J., Tremoli E., Massironi P., Camera M., Cannata A., Alamanni F., et al., Statins in coronary bypass surgery: rationale and clinical use, Ann. Thorac. Surg., 2003, 76, 2132–2140 http://dx.doi.org/10.1016/S0003-4975(03)00820-8[Crossref]

Identifiers

DOI

10.2478/s11536-007-0063-x