Comparison of therapy with simvastatin 80 mg and atorvastatin 80 mg in patients with familial hypercholesterolaemia

This study compared the efficacy of simvastatin 80 mg and atorvastatin 80 m g in the treatment of 26 patients with familial hypercholesterolaemia over 12 weeks using an open crossover trial format. Both, similarly, reduced LDL by 47 +/- 13% and 43 +/- 16% and median triglycerides by 22% and 27% respe ctively. However, atorvastatin reduced HDL by 2 +/- 24% compared with 8 +/- 30% increase with simvastatin (p=0.05) affecting the LDL:HDL ratio achieve d (4.478 +/- 1.56 vs 3.74 +/- 0.93, p=0.001). Atorvastatin raised median fi brinogen by 15% compared with a non-significant 5% increase with simvastati n (p=0.05). Simvastatin reduced lipoprotein (a) by a median 20% compared wi th baseline (p=0.05) compared with 5% for atorvastatin. Side-effects, mostl y gastrointestinal, were seen in four patients (16%) with atorvastatin comp ared with one case of myalgia with simvastatin (4%). We conclude both drugs are equally effective in LDL reduction but that simvastatin is superior in raising HDL and causes fewer side-effects. These results require confirmat ion in larger studies.