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| Slide Lecture Programs |
| Postintervention Continuum of Care: Focus on Lipids |
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November 1, 1999
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| VII: |
Aggressive vs moderate approach to lipid lowering
- Hunninghake et al evaluated the ability of atorvastatin, fluvastatin, lovastatin, and simvastatin to achieve NCEP-recommended LDL-C concentrations.52 The study included 344 patients (53% women and 47% men) ranging between 18 and 80 years of age; 82 had < 2 risk factors, 262 had > 2 risk factors and the mean LDL-C level at baseline was 205 mg/dL. The study consisted of an optional 8-week screening/dietary assessment phase, a 4-week lead-in phase, and a 54-week open-label treatment phase.
- Study subjects were randomized to initial daily doses of atorvastatin 10 mg, fluvastatin 20 mg, lovastatin 20 mg or simvastatin 10 mg and titrated if necessary at 12-week intervals to maximum doses. If the NCEP goal was not achieved at maximum dose, colestipol 5 g/day was titrated to a maximum of 20 mg/day.
- The slide shows cumulative response over time. At all study intervals, significantly more patients taking atorvastatin had reached their NCEP goal (P < 0.05). At week 12, the percentages of patients reaching their goal were atorvastatin (71%), fluvastatin (16%), lovastatin (34%) and simvastatin (41%). At study end, the corresponding figures were atorvastatin (95%), fluvastatin (60%), lovastatin (77%) and simvastatin (83%). All atorvastatin patients who reached goal were on monotherapy and required fewer titration and office visits than patients in the other groups; consequently, mean total cost of care was lowest with atorvastatin.
- The study investigators concluded that atorvastatin was a highly effective treatment in a population at risk for CHD.
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