title: Comparison of the efficacy and tolerability of pitavastatin and atorvastatin: an 8-week, multicenter, randomized, open-label, dose-titration study in Korean patients with hypercholesterolemia.
abstract: BACKGROUND
  Although previous studies have examined the efficacy of pitavastatin, its tolerability and effects on lipid concentrations have not been compared with those of atorvastatin in a multicenter, randomized study.
  
  
  OBJECTIVE
  This trial compared the efficacy and tolerability of pitavastatin and atorvastatin in hypercholesterolemic Korean adults.
  
  
  METHODS
  This 8-week, multicenter, randomized, open-label, dose-titration study was conducted at 18 clinical centers in Korea between May 2005 and February 2006. After a 4-week dietary lead-in period, patients with hypercholesterolemia were randomized to receive either pitavastatin 2 mg/d or atorvastatin 10 mg/d. Patients who had not reached the low-density lipoprotein cholesterol (LDL-C) goal by week 4 received a double dose of the assigned medication for an additional 4 weeks. Efficacy was evaluated in terms of achievement of the National Cholesterol Education Program Adult Treatment Panel III LDL-C goals and changes from baseline in other lipids and high-sensitivity C-reactive protein (hs-CRP). The tolerability profile was assessed by physical and electro-cardiographic examinations, laboratory tests, and recording adverse reactions at all visits.
  
  
  RESULTS
  A total of 268 patients were randomized to treatment, and 222 (82.8%) completed the study (149 women, 73 men; mean age, 59 years; mean weight, 63.5 kg). At the end of the study, there was no significant difference between the pitavastatin and atorvastatin groups in the proportion of patients achieving the LDL-C goal (92.7% [102/110] vs 92.0% [103/112], respectively). In addition, there were no significant differences between groups in terms of the percent changes from baseline in LDL-C, total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C), or hs-CRP. Twenty-six of 136 patients (19.1%) taking pitavastatin reported 35 treatment-emergent adverse reactions; 33 of 132 patients (25.0%) taking atorvastatin reported 39 treatment-emergent adverse reactions. Elevations in creatine kinase were observed in 6 patients (4.4%) in the pitavastatin group and 7 patients (5.3%) in the atorvastatin group. There were no serious adverse drug reactions in either group.
  
  
  CONCLUSIONS
  In these adult Korean patients with hypercholesterolemia, pitavastatin and atorvastatin did not differ significantly in terms of the proportions of patients achieving the LDL-C goal; reductions in LDL-C, total cholesterol, and triglycerides; or increases in HDL-C. Both drugs were well tolerated.
authors.affiliation: Cardiology Division, Yonsei Cardiovascular Center, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul, Republic of Korea.
authors.forename: Sang Hak
authors.initials: SH
authors.lastname: Lee
authors.forename: Namsik
authors.initials: N
authors.lastname: Chung
authors.forename: Jun
authors.initials: J
authors.lastname: Kwan
authors.forename: Doo-Il
authors.initials: DI
authors.lastname: Kim
authors.forename: Won Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Chee Jeong
authors.initials: CJ
authors.lastname: Kim
authors.forename: Hyun Seung
authors.initials: HS
authors.lastname: Kim
authors.forename: Si Hoon
authors.initials: SH
authors.lastname: Park
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.forename: Dong Gu
authors.initials: DG
authors.lastname: Shin
authors.forename: Yung Woo
authors.initials: YW
authors.lastname: Shin
authors.forename: Wan-Joo
authors.initials: WJ
authors.lastname: Shim
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Ahn
authors.forename: Kyeong
authors.initials: K
authors.lastname: Ho Yun
authors.forename: Myeong-Ho
authors.initials: MH
authors.lastname: Yoon
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Cha
authors.forename: Si-Wan
authors.initials: SW
authors.lastname: Choi
authors.forename: Seong Wook
authors.initials: SW
authors.lastname: Han
authors.forename: Min Su
authors.initials: MS
authors.lastname: Hyon
mesh_terms: D000069059:Atorvastatin; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D007723:Korea; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D014280:Triglycerides; D002784:Cholesterol; D000069059:Atorvastatin; C108475:pitavastatin