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A Multicenter, Eight-Week Treatment, Single-Step Titration, Open-Label Study Assessing the Percentage of Korean Dyslipidemic Patients Achieving LDL Cholesterol Target with Atorvastatin Starting Doses of 10 mg, 20 mg and 40 mg

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Abstract

Background

This study was designed to evaluate the safety and efficacy of algorithm-based atorvastatin therapy initiated at different starting doses of 10, 20, and 40 mg in Korean dyslipidemic patients.

Methods

Five hundred seventy-four patients were screened, and 425 were enrolled (low risk, n = 29; intermediate risk, n = 45; high risk, n = 351). The starting dose depended on a patient’s cardiovascular risk and LDL-cholesterol (LDL-C) levels.

Results

Of the patients, 253 (59.5%), 63 (14.8%) and 109 (25.6%) patients were assigned at baseline to 10 mg, 20 mg and 40 mg atorvastatin, respectively. 390 patients (91.8%) completed the study, and 35 discontinued prematurely. No patient in the low or intermediate risk groups was titrated to 80 mg at Week 4, whereas, 26 in the high risk group were. 81.9% of patients achieved their LDL-C target at Week 4, which was sustained through to Week 8 (86.0%). 89.1% of patients who were not titrated achieved their LDL-C target at Week 8, and 82.1% of patients who were titrated 1 step up achieved their LDL-C target at Week 8. Overall, about 40% reduction in LDL-C, non-HDL-C levels, and LDL-C/HDL-C ratio was observed during the follow-up. Triglyceride was reduced by ∼10% by Week 8. HDL cholesterol was slightly increased over 8 weeks (2.6%). Atorvastatin was well tolerated at all dose levels.

Conclusions

Patient-tailored statin therapy according to an individual’s risk category and LDL-C levels was safe and effective with a quick achievement of LDL-C target in Korean dyslipidemic patients.

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References

  1. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–78.

    Article  CAS  PubMed  Google Scholar 

  2. Grundy SM, Cleeman JI, Merz CN, Brewer Jr HB, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004;110:227–39.

    Article  PubMed  Google Scholar 

  3. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, et al. For the ESC Committee for Practice Guidelines. European guidelines on cardiovascular disease prevention in clinical practice: executive summary. Atherosclerosis. 2007;194:1–45.

    Article  CAS  PubMed  Google Scholar 

  4. Monkman D. Treating dyslipidaemia in primary care. The gap between policy and reality is large in the UK. Br Med J. 2000;121:1299–300.

    Article  Google Scholar 

  5. Pearson TA, Laurora I, Chu H, Kafonek S. The lipid treatment assessment project (L-TAP): a multicenter survey to evaluate the percentages of dyslipidemic patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals. Arch Intern Med. 2000;160:459–67.

    Article  CAS  PubMed  Google Scholar 

  6. Marcelino JJ, Feingold KR. Inadequate treatment with HMG-CoA reductase inhibitors by health care providers. Am J Med. 1996;100:605–10.

    Article  CAS  PubMed  Google Scholar 

  7. Andrade SE, Walker AM, Gottlieb LK, Hollenberg NK, Testa MA, Saperia GM, et al. Discontinuation of antihyperlipidemic drugs—do rates reported in clinical trials reflect rates in primary care settings? N Engl J Med. 1995;332:1125–31.

    Article  CAS  PubMed  Google Scholar 

  8. Jones PH, McKenney JM, Karalis DG, Downey J. Comparison of the efficacy and safety of atorvastatin initiated at different starting doses in patients with dyslipidemia. Am Heart J. 2005;149(1):e1.

    Article  Google Scholar 

  9. Schrott H, Fereshetian A, Knopp Knopp RH, Bays H, Jones PH, Littlejohn 3rd TW, et al. A multicenter, placebo controlled, dose-ranging study of atorvastatin. J Cardiovasc Pharmacol Ther. 1998;3:119–24.

    Article  CAS  PubMed  Google Scholar 

  10. Muls E, De Backer G, Brohet C, Heller F. The efficacy of atorvastatin in treating patients with hypercholesterolaemia to target LDL-cholesterol goals: the LIPI-GOAL trial. Acta Cardiol. 2001;56:109–14.

    Article  CAS  PubMed  Google Scholar 

  11. Andrews T, Ballantyne C, Hsia J, Kramer J. Achieving and maintaining National Cholesterol Education Program low-density lipoprotein cholesterol goals with five statins. Am J Med. 2001;111:185–91.

    Article  CAS  PubMed  Google Scholar 

  12. McKenney JM, Davidson MH, Saponaro J, Thompson PD, Bays HE. Use of a treatment algorithm to achieve NCEP ATP III goals with atorvastatin. J Cardiovasc Pharmacol. 2005;46:594–9.

    Article  CAS  PubMed  Google Scholar 

  13. Deerochanawong C, Buranakitjaroen P, Nitiyanant W, Suwantamee J, Piamsomboon C, Vongthavaravat V, et al. The Atorvastatin Goal Achievement Across Risk Levels: (ATGOAL) study in Thailand. J Med Assoc Thai. 2007;90:72–81.

    PubMed  Google Scholar 

  14. Agresti A. Categorical data analysis, vol. 2. NJ: Wiley Series in Probability and Statistics, Wiley; 2002. p. 18–20. Chapter 1.

    Google Scholar 

  15. Liu J, Hong Y, D’Agostino Sr RB, Wu Z, Wang W, Sun J, et al. Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi-Provincial Cohort Study. JAMA. 2004;291:2591–9.

    Article  CAS  PubMed  Google Scholar 

  16. Cannon CP, Braunwald E, McCabe CH, et al. Comparison of intensive and moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med. 2004;350:1495–504.

    Article  CAS  PubMed  Google Scholar 

  17. Newman CB, Palmer G, Silbershatz H, et al. Safety of atorvastatin derived from analysis of 44 completed trials in 9416 patients. Am J Cardiol. 2003;92:670–6.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This study was supported by a grant from Pfizer Pharmaceuticals Korea Ltd.

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Correspondence to Ki-Bae Seung or Hyo-Soo Kim.

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Lee, C.W., Baek, SH., Hong, TJ. et al. A Multicenter, Eight-Week Treatment, Single-Step Titration, Open-Label Study Assessing the Percentage of Korean Dyslipidemic Patients Achieving LDL Cholesterol Target with Atorvastatin Starting Doses of 10 mg, 20 mg and 40 mg. Cardiovasc Drugs Ther 24, 181–188 (2010). https://doi.org/10.1007/s10557-010-6225-0

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