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  • Atorvastatin calcium: EFFICACY(8)

Comparison of efficacy by dyslipidemic type Analysis of pooled data by dyslipidemic type from clinical tri-ls has indicated that atorvastatin appears to lower preferen-ially the lipoprotein particles that are most elevated within ach dyslipidemic state rather than to target only one lipoprotein fraction . In patients with hypercholesterolemia (Fredrickson type IIa dyslipidemia), typically characterized by elevated levels of LDL-C, with normal or slightly increased triglyceride levels , atorvastatin significantly reduced LDL-C levels while moderately lowering triglyceride levels (Table 3).

TABLE 3 Efficacy of atorvastatin 10 mg/day in patients by Fredrickson type (mean percentage change from baseline)

Lipidparameter Type IIa (n=935) Type IIb (n=550) > — I9 e2 p= yn T(
LDL-C -36 -35 -26
Apo B -28 -28 -25
Total cholesterol -27 -27 -25
Triglyceride -14 -24 -29
VLDL-C -15 -28 -41
HDL-C +6 +10 +13
Apo B:HDL-C -31 -34 -33
Non-HDL-C:HDL-C -37 -38 -38

Data pooled from several studies. Apo B Apolipoprotein B; HDL-C High density lipoprotein cholesterol; LDL-C Low density lipoprotein cholesterol; VLDL-C Very low density lipoprotein cholesterol. Reprinted from reference 39

In patients with combined hyperlipidemia (Fredrickson type IIb dyslipidemia) in whom both LDL-C and triglyceride levels are significantly elevated, atorvastatin reduced LDL-C levels (as with type IIa patients) and significantly lowered triglyceride levels to a greater extent than in type IIa patients. In patients with isolated hypertriglyceridemia (Fredrickson type IV dyslipidemia) who are characterized by significantly raised triglyceride levels and normal or slightly raised LDL-C levels, atorvastatin produced substantial reductions in triglyceride and VLDL-C levels and moderate reductions in LDL-C levels (Table 3). In addition, atorvasta-tin increased HDL-C levels in all dyslipidemic states. An assessment of the overall impact of atorvastatin to improve lipid profiles (a measure of the non-HDL-C to HDL-C and the apo B to HDL-C ratios) in the different patient populations demonstrated that atorvastatin effectively reduced these ratios by similar amounts in all patient types, despite the dissimilarity in the patients’ baseline characteristics (Table 3). Buy Asthma Inhalers Online

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