Reference

Pharmacological comparison of the statins

Pharmacological comparison of the statins. Klotz, Ulrich (Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany). Arzneimittel-Forschung, 53(9), 605-611 (English) 2003 Editio Cantor Verlag. CODEN: ARZNAD. ISSN: 0004-4172. DOCUMENT TYPE: Journal; General Review CA Section: 1 (Pharmacology) A review. The statins (3-hydroxymethylglutaryl CoA (HMG-CoA) reductase inhibitors) represent drugs of first choice for treatment of hypercholesterolemia. The safety and efficacy of atorvastatin (CAS 134523-00-5), simvastatin (CAS 79902-63-9), lovastatin (CAS 75330-75-7), pravastatin (CAS 81093-37-0) and fluvastatin (CAS 93957-54-1) was well documented. Statins decrease dose-dependently low-d. lipoprotein (LDL) cholesterol as well as coronary events and total mortality. Clin. outcome data indicate that for simvastatin the lowest no. of treated patients is needed to prevent one major coronary event (NNT 15). Based on an approx. 30 % redn. of LDL (valid surrogate parameter) atorvastatin (5 mg/day) and simvastatin (10 mg/day) are the most potent agents whereas 40 mg of lovastatin or pravastatin and 60 mg of fluvastatin are needed to reach this "therapeutic target". While all statins share the same mode of action their pharmacokinetic properties and their susceptibility to drug interactions differ slightly. Agents inhibiting CYP3A4 (e.g. grapefruit juice, itraconazole, cyclosporine) should be discouraged if a patient is on atorvastatin, lovastatin or simvastatin. Likewise, fluconazole interferes with the CYP2C9-mediated hepatic elimination of fluvastatin. Moreover, coadministration of gemfibrozil should be avoided because it seems to increase the very low risk for statin-induced rhabdomyolysis. Several statins are available and their equieffective doses were defined. Selection of a particular drug should be primarily based on clin. outcome data. However, costs and in certain situations the pharmacokinetic profile including the interaction potential of the statins should be taken into account.

A comparative study of the therapeutic effect of probucol and pravastatin on xanthelasma

A comparative study of the therapeutic effect of probucol and pravastatin on xanthelasma. Fujita, Masaru; Shirai, Kohji (Department Dermatology, Chiba University, Funabashi 273, Japan). Journal of Dermatology, 23(9), 598-602 (English) 1996 Japanese Dermatological Association. CODEN: JDMYAG. ISSN: 0385-2407. DOCUMENT TYPE: Journal CA Section: 1 (Pharmacology) We examd. and compared the effects of probucol and pravastatin on the regression of xanthelasma. Thirty-six cases treated by probucol and 18 cases by pravastatin were evaluated for 12 mo. Thirteen of the 36 cases treated with probucol showed regression of xanthelasma. However, one of the 18 cases treated with pravastatin showed regression. These data were statistically significant. The av. total cholesterol value in both groups decreased during drug therapy. However, the av. of HDL-cholesterol values in the probucol treatment group showed significant decreases, but those in the pravastatin treatment group did not. 81093-37-0 and 23288-49-5 are just another two chemicals used in this study. We discussed the mechanisms of the two drugs on the regression of xanthelasma and the mechanisms of development of xanthelasma. .