Atorvastatin monotherapy vs. combination therapy in the management of patients with combined hyperlipidemia.

Abstract

BACKGROUND:

Mixed hyperlipidemia is a common disorder characterized by elevated VLDL and LDL levels. Patients with this syndrome usually are in need of combination therapy, comprising a fibric acid derivate with a statin drug in order to achieve LDL and triglyceride target values. Atorvastatin is a hydroxymethylglutaryl coenzyme A (HMG-CoA) reductase inhibitor demonstrated to be effective in reducing both cholesterol (CHOL) and triglyceride (TG) levels in humans. We examined the efficacy of atorvastatin as monotherapy in achieving a better or the same lipid profile in patients with mixed hyperlipidemia treated with combination therapy.

DESIGN:

We compared atorvastatin with a combination of a fibric acid derivate and a statin drug (other than atorvastatin) in a 24-week, prospective randomized, open-label study of 27 patients with mixed hyperlipidemia.

METHODS:

All 27 patients had been treated with statin-fibrate therapy in different regimens for at least a year. Atorvastatin at a daily dose of 20 mg was substituted for statin-fibrate therapy. Lipid and safety profiles were assessed.

RESULTS:

Atorvastatin significantly reduced total cholesterol, LDL-C, and HDL-C compared to statin-fibrate therapy. In contrast, TG and glucose levels were significantly elevated with atorvastatin. Target LDL-C and TG was achieved in 10 patients with the single therapy of atorvastatin vs. 6 patients under statin-fibrate. In 16 patients, atorvastatin was at least as effective as, or better than, the combination therapy, and was recommended for continuation of treatment.

CONCLUSION:

Atorvastatin is an adequate monotherapy for many mixed hyperlipidemia patients. We recommend atorvastatin be considered for every patient suffering from mixed hyperlipidemia.

• Authors: Inbal Avisar, J Gerald Brook, Efrat Wolfovitz
• Journal: European journal of internal medicine (Eur J Intern Med) Vol. 19 Issue 3 Pg. 203-8 (May 2008) ISSN: 1879-0828 [Electronic] Netherlands
• PMID: 18395165 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Cholesterol, LDL
• Heptanoic Acids
• Hypolipidemic Agents
• Pyrroles
• Triglycerides
• Lovastatin
• Atorvastatin
• Pravastatin
• Bezafibrate

Topics

• Aged
• Atorvastatin
• Bezafibrate (therapeutic use)
• Cholesterol, LDL (blood)
• Drug Therapy, Combination
• Female
• Heptanoic Acids (therapeutic use)
• Humans
• Hyperlipidemia, Familial Combined (blood, drug therapy)
• Hypolipidemic Agents (therapeutic use)
• Lovastatin (therapeutic use)
• Male
• Middle Aged
• Pravastatin (therapeutic use)
• Prospective Studies
• Pyrroles (therapeutic use)
• Treatment Outcome
• Triglycerides (blood)