Atorvastatin calcium: EFFICACY(6)
Patients with combined (mixed) hyperlipidemia
Comparative studies of other HMG-CoA reductase inhibi-ors, described above, also comprised patients with elevated LDL-C and triglyceride levels, ie, patients with combined mixed) hyperlipidemia. Atorvastatin effectively reduced oth LDL-C and triglyceride levels in this patient population. Comparison of effectiveness at starting doses showed ator-astatin to be more effective than the other HMG-CoA reduc-ase inhibitors (see above).
In other studies involving patients with combined hyper-ipidemia, atorvastatin has been compared with other lipid-owering agents, namely fenofibrate and niacin. Analysis of datain a comparative trial of fenofibrate conducted in Canada showed that atorvastatin favourably affected both chol-?sterol-rich and triglyceride-rich lipoprotein particles . The ignificant reductions in cholesterol-rich particles (LDL-C, to-al cholesterol, LDL triglycerides, apo B and LDL-apo B) with torvastatin 10 or 20 mg/day are similar to those in patients with primary hypercholesterolemia. These reductions were significantly greater than those with 300 mg/day fenofibrate. ‘n contrast, fenofibrate treatment resulted in greater decreases n triglyceride-rich lipoprotein particles (triglycerides, VLDL-C, VLDL triglycerides and VLDL-apo B) compared with treatment with atorvastatin 10 mg/day. However, de-reases in these triglyceride-rich lipoprotein particles with itorvastatin 20 mg/day were similar to those seen with fenofi-Drate (300 mg/day), except for the decrease in VLDL triglyceride levels, which remained significantly greater with fenofi-Drate treatment. Atorvastatin treatment (20 mg/day) resulted n a greater reduction in the non-HDL-C to HDL-C ratio or the :otal apo B to HDL-C ratio than did fenofibrate (300 mg/day). These ratios may offer a measure of the overall impact of ipid-lowering agents in improving lipid profiles and have een suggested to be good predictors of CAD status. buy ortho tri-cyclen