PMID- 21193154
OWN - NLM
STAT- MEDLINE
DCOM- 20110519
LR  - 20121115
IS  - 1878-5050 (Electronic)
IS  - 1567-5688 (Linking)
VI  - 11
IP  - 3
DP  - 2010 Dec
TI  - Pitavastatin - from clinical trials to clinical practice.
PG  - 15-22
LID - 10.1016/S1567-5688(10)71065-5 [doi]
AB  - Managing dyslipidaemia is central to the management of cardiovascular disease. 
      Most statins can reduce the 5-year incidence of major vascular events by 20%. In 
      Europe, however, up to 53% of statin-treated patients fail to attain their 
      low-density lipoprotein-cholesterol (LDL-C) target and residual risk remains 
      high, even when targets are reached. Reasons for this include under-treatment due 
      to insufficient starting doses/failure to uptitrate; poor persistence with 
      therapy due to adverse events (AEs) or drug-drug interactions (DDIs); and failure 
      to treat non-LDL-C risk factors, such as high triglycerides (TGs) and low 
      high-density lipoprotein-C (HDL-C). Phase III and IV studies demonstrate that 
      pitavastatin 1-4 mg has a similar or greater lipid-lowering efficacy to 
      atorvastatin 10-20 mg, simvastatin 20-40 mg and pravastatin 10-40 mg, and is 
      well-tolerated with a low incidence of adverse events (AEs). The SmPC recommends 
      a usual starting dose of 1 mg, with dose-escalation if required. However, since 
      the lower doses (1-2 mg) bring the majority of people with hypercholesterolaemia 
      or combined dyslipidaemia to LDL-C target, the need for pitavastatin uptitration 
      and the risk of under-treatment is low. In addition to reducing LDL-C, 
      pitavastatin has a sustained beneficial effect on other atherogenic lipids, 
      including TGs and HDL-C. Recent studies reveal that pitavastatin reduces coronary 
      atheroma plaque volume as efficiently as atorvastatin and can improve the 
      composition of coronary plaques, effects that are likely to reduce the risk of CV 
      endpoints in patients with acute coronary syndrome. Moreover, pitavastatin has a 
      number of pleiotropic effects that can reduce inflammation and lipid oxidation, 
      improve endothelial function, reduce the metabolic changes associated with 
      adiposity, and improve glucose metabolism and renal function. Compared to other 
      statins, pitavastatin has a unique metabolic profile that could reduce the risk 
      of DDIs, thereby providing a clear benefit in patients receiving polypharmacy. 
      Overall, pitavastatin is a well tolerated and effective treatment for patients 
      with hypercholesterolaemia and combined dyslipidaemia, especially in those with 
      low HDL-C, and it should help improve LDL-C-target attainment rates by reducing 
      the risk of under-treatment, minimising AE rates, and reducing the risk of DDIs 
      in people requiring polypharmacy. Future and ongoing studies will directly 
      compare the effects of pitavastatin vs. other statins on hard clinical endpoints.
CI  - Copyright A(c) 2010 Elsevier Ireland Ltd. All rights reserved.
FAU - Masana, Luis
AU  - Masana L
AD  - Vascular Medicine and Metabolism Unit, University Hospital Sant Joan, 
      IISPVCIBERDEM Rovira i Virgili University, Reus, Spain. luis.masana@urv.cat
LA  - eng
PT  - Journal Article
PT  - Review
PL  - Netherlands
TA  - Atheroscler Suppl
JT  - Atherosclerosis. Supplements
JID - 100973461
RN  - 0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
RN  - 0 (Quinolines)
RN  - M5681Q5F9P (pitavastatin)
SB  - IM
MH  - Animals
MH  - Clinical Trials as Topic
MH  - Dyslipidemias/drug therapy
MH  - Humans
MH  - Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use
MH  - Hypercholesterolemia/*drug therapy
MH  - Quinolines/*therapeutic use
EDAT- 2011/01/05 06:00
MHDA- 2011/05/20 06:00
CRDT- 2011/01/04 06:00
PHST- 2011/01/04 06:00 [entrez]
PHST- 2011/01/05 06:00 [pubmed]
PHST- 2011/05/20 06:00 [medline]
AID - S1567-5688(10)71065-5 [pii]
AID - 10.1016/S1567-5688(10)71065-5 [doi]
PST - ppublish
SO  - Atheroscler Suppl. 2010 Dec;11(3):15-22. doi: 10.1016/S1567-5688(10)71065-5.