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Comparative efficacy and tolerability of low-dose pravastatin versus lovastatin in patients with hypercholesterolemia.

Author(s): Strauss WE, Lapsley D, Gaziano JM

Affiliation(s): Department of Medicine and the Massachusetts Veterans Epidemiology Research and Information Center, Department of Veterans Affairs MedicalCenter, West Roxbury 02132, USA.

Publication date & source: 1999-03, Am Heart J., 137(3):458-62.

Publication type: Clinical Trial; Randomized Controlled Trial

BACKGROUND: The HMG CoA reductase inhibitors have quickly become the most widely prescribed family of agents for the treatment of patients with elevated low-density lipoprotein (LDL) cholesterol. The incidence of side effects with these agents increases as the dose increases within the recommended dosage range. A lower dosage presumably would have a lower incidence of adverse effects. In addition, lower doses should translate into reduced drug costs. METHODS AND RESULTS: We compared the efficacy of 10 mg of pravastatin and 10 mg of lovastatin in a randomized, crossover design trial among 30 patients with hypercholesterolemia. At baseline, their total cholesterol and LDL cholesterol levels were 249.0 +/- 27.3 and 185.1 +/- 25.5 mg/dL. After 4 weeks of treatment with lovastatin, the total cholesterol and LDL cholesterol levels fell to 202.8 +/- 29.6 and 141.0 +/- 25.3 mg/dL, decreases of 19% and 24%, respectively. Four weeks of pravastatin treatment resulted in levels of 212.6 +/- 30.8 and 150.5 +/- 25.5 mg/dL, or 15% and 19%, respectively. CONCLUSIONS: There were highly significant changes in total cholesterol and LDL cholesterol levels with each agent and no differences in effect between the 2 agents. In 13 (43%) of the 30 patients, LDL levels were reduced to </=130 mg/dL with one of the agents. Both agents were generally well tolerated, with no clinically important change in liver function tests or creatinine kinase levels.

Page last updated: 2006-01-31

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