A COMPARATIVE-STUDY OF POLICOSANOL VERSUS PRAVASTATIN IN PATIENTS WITH TYPE-II HYPERCHOLESTEROLEMIA

This randomized, double-masked study compared the short-term efficacy and tolerability of policosanol and pravastatin in patients with type II hypercholesterolemia. After following a step I cholesterol-lo werin g diet for 6 weeks, 24 patients with type II hypercholesterolemia were randomly assigned to receive policosanol or pravastatin administered at the same dose (10 mg/d) for 6 weeks. Both groups mere statistically similar at randomization. Policosanol significantly reduced total cho lesterol (15.7%), low-density lipoprotein (LDL) cholesterol (24.2%), a nd triglycerides (8.7%), as web as the atherogenic ratios of total cho lesterol to high-density lipoprotein (HDL) cholesterol (25.7%), and LD L cholesterol to HDL cholesterol (33.0%). Pravastatin significantly lo wered total cholesterol by 15.3%, LDL cholesterol by 19.6%, triglyceri des by 13.9%, and the atherogenic ratios of total cholesterol to HDL c holesterol (18.7%) and LDL cholesterol to HDL cholesterol (22.8%). Mea n values of HDL cholesterol mere significantly increased by 13.6% afte r treatment with policosanol, and were increased by 4.7% after treatme nt with pravastatin. Comparisons between groups showed that the percen tage change in LDL and HDL cholesterol levels, and in atherogenic rati os were significantly higher in the policosanol group than in the prav astatin group. Both drugs were well tolerated. A significant increase in mean aspartate aminotransferase level was observed in the pravastat in group, but individual values remained within the normal range. No p atient withdrew from the study because of adverse events. Four moderat e adverse events (nausea, dizziness, abdominal pain, and pruritus) wer e reported by pravastatin-treated patients. The other adverse events r eported (five in each group) were classified as mild. These results su ggest that both policosanol and pravastatin are suitable alternatives for treating type II hypercholesterolemia, but that policosanol admini stered at 10 mg/d shows modest advantages compared with pravastatin ad ministered at the same dose.