CROSSOVER TRIAL OF SIMVASTATIN VERSUS PRAVASTATIN IN PATIENTS WITH PRIMARY HYPERCHOLESTEROLEMIA

The effects of simvastatin and pravastatin administered alone at initi al doses of 5 and 10 mg/day, respectively, on normalization of abnorma l lipid metabolism In patients with hypercholesterolemia were evaluate d by a crossover method. Patients whose serum levels of total choleste rol (TC) were greater than or equal to 220 mg/dl were randomly divided into two groups, and one of the groups (group S-P: 17 patients) was t reated with simvastatin first and then with pravastatin whereas the ot her group (group P-S: 19 patients) was treated with pravastatin first and then with simvastatin. Simvastatin or pravastatin was replaced wit h the other drug after 8-week administration in each group, These drug s were administered for 8 weeks each. Simvastatin and pravastatin sign ificantly reduced the following;lng serum lipids as compared with the levels in the observation period: TC by 23.2 +/- 8.1% and 18.1 +/- 10. 9%, triglyceride (TG) by 13.0 +/- 24.7% and 5.8 +/- 47.1%, and low-den sity lipoprotein cholesterol (LDL-C) by 31.3 +/- 10.1% and 23.1 +/- 14 .3%, respectively. TC and LDL-C levels were significantly (p < 0.001) lower and decreased to significantly (p < 0.001) greater degrees after simvastatin treatment than after pravastatin treatment. TC was normal ized in 77.8% of the patients (28 of 36) after simvastatin treatment a nd in 68.9% of the patients (23 of 36) after pravas tatin treatment. L DL-C was normalized in 63.9% of the patients (23 of 36) after simvasta tin treatment and in 44.4% of the patients (16 of 36) after pravastati n treatment. The percentage of patients whose LDL-C was normalized by simvastatin was significantly (p < 0.05) higher as compared with prava statin, Results of this trial, which was conducted by a crossover meth od, show that the initial dose of simvastatin reduces serum cholestero l and LDL-C more potently than the initial dose of pravastatin in pati ents with hypercholesterolemia.