P. Ferrari et al., PRAVASTATIN IN THE TREATMENT OF PRIMARY H YPERCHOLESTEROLEMIA - A SWISS MULTICENTER STUDY, Schweizerische medizinische Wochenschrift, 123(37), 1993, pp. 1736-1741
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.