PRAVASTATIN IN THE TREATMENT OF PRIMARY H YPERCHOLESTEROLEMIA - A SWISS MULTICENTER STUDY

Conventional lipid-lowering agents displayed only limited efficacy in lowering total and LDL cholesterol and a high incidence of side effect s. Pravastatin is a new potent cholesterol-lowering agent, which selec tively inhibits hepatic HMG-CoA-reductase. In a double-blind, placebo- controlled Swiss multicenter study with determination of lipids and li poprotein in a central laboratory, the efficacy and safety of 6 months ' therapy with pravastatin was evaluated in 50 patients with mild hype rcholesterolemia and additional coronary risk factors. Compared to bas eline and after 26 weeks' therapy, pravastatin significantly reduced t otal cholesterol (pravastatin vs placebo, -17% vs +7%, p<0.0001) and L DL cholesterol (-26 vs +2%, p<0.0001). The total/HDL cholesterol ratio (= ''atherogenic index'') was comparable in the two groups at baselin e (5.9+/-1.1 vs 6.3+/-0.9), and was distinctly lowered by pravastatin but not placebo (-20 vs 0%, p<0.0001). In 11 patients in whom the redu ction of serum total cholesterol after 13 weeks' treatment with 20 mg pravastatin was still below target (on average -9.1%), doubling of the dose produced a further decrease of 4.3%. Serum HDL cholesterol and s erum triglyceride levels did not change significantly during pravastat in treatment as compared to baseline and placebo. Pravastatin was well tolerated during the 26 weeks without relevant subjective side-effect s. There were 5 dropouts during the study, 2 patients in the pravastat in group and 3 in the placebo group. These findings document that prav astatin, adminstered in a single daily dose of 20 to 40 mg, effectivel y lowers serum cholesterol and total-/HDL-cholesterol improving action and is well tolerated.