Meta-analysis confirms newest statin ‘equal to atorvastatin’
MedWire News: Pitavastatin and low-dose atorvastatin have equivalent efficacy and safety for the treatment of dyslipidemia, results of a meta-analysis indicate.
Pitavastatin, the newest statin drug, was also superior to atorvastatin in certain respects, although the clinical relevance of these differences remains to be established.
The meta-analysis was undertaken by Nalinee Poolsup (Silpakorn University, Nakhon-Pathom, Thailand) and colleagues and is reported in the Journal of Clinical Pharmacy and Therapeutics.
By searching electronic databases they identified seven randomized controlled trials that evaluated pitavastatin at the recommended dose of 2-4 mg/day with atorvastatin 10-20 mg/day in 1529 patients with dyslipidemia. There was no evidence of population bias, the authors note.
The studies lasted between 8 and 52 weeks and all reported the percent change from baseline in lipid levels.
In terms of efficacy, pitavastatin and atorvastatin were equally effective at reducing levels of low-density lipoprotein (LDL) cholesterol (mean difference 0.97%), total cholesterol (1.22%), and triglycerides (2.3%), report Poolsup et al.
In addition, pitavastatin was superior to atorvastatin at elevating levels of high-density lipoprotein (HDL) cholesterol (mean difference 1.78%).
With regard to safety, the risk for adverse events did not differ significantly between pitavastatin and atorvastatin (risk ratio 0.87). The most commonly reported events in both groups were gastrointestinal symptoms, myalgia, fatigue, and headache.
Discussing the study, the researchers note that pitavastatin has equivalent efficacy and safety to that of atorvastatin, as well as some potential advantages. These include superior ability to raise HDL cholesterol and a low propensity for cytochrome P450-mediated drug-drug interactions.
"Its effectiveness relative to higher doses of atorvastatin remains to be investigated," they write. "In addition, the comparative long-term effects of pitavastatin relative to other statins remain to be established."
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By Joanna Lyford