SISANews

Pitavastatina e atorvastatina a confronto

E' la prima meta-analisi di confronto fra l'ultima nata tra le statine e quella più diffusa; pitavastatina alla dose di 2 o 4 mg verso atorvastatina alla dose di 10 o 20 mg. In quanto ad efficacia sul colesterolo LDL non ci sono differenze, la pitavastatina è però più efficace dell'atorvastatina nell'aumentare il colesterolo HDL. Buona e comparabile la tollerabilità dei due farmaci. Diversamente da atorvastatina, la pitavastatina è poco metabolizzata dal citocromo P450 e questo potrebbe essere un vantaggio nei pazienti in terapia farmacologica multipla, quando l'interazione di più farmaci in una via metabolica comune aumenta il rischio di effetti collaterali.

Meta-analysis of the comparative efficacy and safety of pitavastatin and atorvastatin in patients with dyslipidaemia

Poolsup N, Suksomboon N, Wongyaowarat K, Rungkanchananon B, Niyomrat P, Kongsuwan S

J Clin Pharm Ther 2012;37:166-172

OBJECTIVE: Pitavastatin is the latest available statin. It has been shown to be effective in the treatment of dyslipidaemia. This meta-analysis was aimed at evaluating the effects of pitavastatin on lipid profiles in patients with dyslipidaemia compared with atorvastatin.

METHODS: Clinical trials were identified through electronic searches (MEDLINE, CINAHL, EBM review, and the Cochrane Library) up to January 2011 and historical searches of relevant articles. Studies were included in the meta-analysis if they were (i) randomized controlled trials that evaluated pitavastatin at the recommended dose vs. atorvastatin in patients with dyslipidaemia, (ii) lasting at least 6weeks, (iii) reporting total cholesterol (TC), LDL-C, HDL-C or triglyceride (TG) levels and (iv) published in English. Treatment effect was estimated with the mean difference in the per cent changes in lipid profiles from baseline to final assessment between pitavastatin and atorvastatin.

RESULTS: Seven trials involving 1529 patients were included. Pitavastatin reduced LDL-C level as effectively as atorvastatin (mean difference 0.97%, 95% CI -0.48% to 2.42%). The reductions in TC and TG levels were also comparable between the two drugs. The mean differences were 1.22% (95% CI -0.55% to 2.99%) and 2.3% (95% CI -1.06% to 5.65%), respectively. However, HDL-C levels increased significantly more with pitavastatin than with atorvastatin (mean difference 1.78%, 95% CI 0.20-3.36%, P=0.03). WHAT IS NEW AND

CONCLUSIONS: Pitavastatin was as effective as atorvastatin in lowering LDL-C, TC and TG levels. Pitavastatin was marginally superior to atorvastatin in increasing HDL-C levels.

J Clin Pharm Ther 2012;37:166-172