Open AccessTime as a Variable With Niacin Extended‐Release/Lovastatin vs. Atorvastatin and Simvastatin
Author(s) -
Bays Harold E.,
McGovern Mark E.
Publication year - 2005
Publication title -
preventive cardiology
Language(s) - English
Resource type - Journals
eISSN - 1751-7141
pISSN - 1520-037X
DOI - 10.1111/j.0197-3118.2005.04289.x
Subject(s) - lovastatin , niacin , simvastatin , atorvastatin , medicine , cholesterol , pharmacology , lipoprotein , hmg coa reductase , endocrinology , reductase , chemistry , biochemistry , enzyme
Time may be an important variable when evaluating the efficacy of lipid‐altering drugs. In this analysis of the Advicor Versus Other Cholesterol‐Modulating Agents Trial Evaluation, niacin extended‐release/lovastatin 1000/40 mg was as effective as atorvastatin 10 mg and more effective than simvastatin (both 10 mg and 20 mg) in achieving low‐density lipoprotein cholesterol and non – high‐density lipoprotein cholesterol treatment goals. The titration schedule for this study included the initiation of niacin‐extended release/lovastatin 500/20 mg once a day for 4 weeks, titrated to the starting dose of 1000/40 mg after 4 weeks, and then titrated to the final dose of 2000/40 mg. The titration schedule for both atorvastatin and simvastatin was 10 mg per day for 8 weeks and then titrated to 40 mg per day. Using this schedule, 50% of niacin extended‐release/lovastatin and atorvastatin patients reached low‐density lipoprotein cholesterol and non –high‐density lipoprotein cholesterol treatment goals within approximately 7 weeks, compared with simvastatin, in which 50% reached both treatment goals in 13–14 weeks. These time differences may have potential clinical relevance in reducing coronary heart disease risk.