Atorvastatin calcium: EFFICACY(9)
Patients with FH
FH is an autosomal hereditary disordercharacterized by high levels of plasma total cholesterol and LDL-C, and early onset of CAD . The risk of CAD is increased fourfold in patients with FH compared with patients without FH. Total cholesterol levels are roughly twice those of normal levels in adult patients who are heterozygous for FH and four times those of normal levels in patients homozygous for FH.Treatmentoptions for patients with FH are often limited to combination therapy of HMG-CoA reductase inhibitor and bile acid sequestrant resin (colestipol or cholestyramine) to obtain significant reductions in LDL-C (50% or greater), which are required to attain target levels . However, disadvantages of using resins as long term therapy include increased frequency of side effects and patient intolerability. In some instances, LDL apheresis is also used. buy prednisone
In a one-year, multicentre, comparative, randomized study in patients with heterozygous FH conducted inCanada, a combination of atorvastatin (40mg/day) and colestipol (20 g/ day) was significantly more effective in lowering total cholesterol and LDL-C levels compared with a combination of simvastatin (40mg/day) and colestipol (20 g/day); LDL-C was reduced by 53% in the atorvastatin-colestipol combination group compared with a reduction of 46% in the simvastatin-colestipol combination group . Atorvastatin 80mg/day monotherapy was as effective as the combination of ator-vastatin-colestipol and more effective than the simvastatin-colestipol combination in lowering LDL-C and triglyceride levels. Triglyceride levels were lowered by 33% with atorvas-tatin monotherapy in contrast to a reduction of 10% observed in patientstreated with a combination of simvastatin and colestipol. An analysis of patients in this study who had definite CAD or two additional risk factors for CAD showed that more patients in the atorvastatin monotherapy group achieved and maintained NCEP target LDL-C levels than did patients on simvastatin-colestipol combination therapy. Additionally, atorvastatin monotherapy was more tolerable than colestipol combination therapy, resulting in higher compliance rates with the atorvastatin monotherapy patients.