SAN FRANCISCO, CA—Pitavastatin is an acceptable alternative for patients who are intolerant to other statins, according to research presented at ACC.13, the American College of Cardiology’s 62nd Annual Scientific Session by Bobby Hollaway, CNA, from the Intermountain Medical Center, Murray, UT.
Approximately 10–15% of patients are unable to tolerate statins due to the development of myalgias. Dr. Hollaway and colleagues investigated whether pitavastatin, a new water-soluble statin with fewer cytochrome P450 interactions that does not lower Co-enzyme Q10, would be better tolerated and efficacious in patients intolerant to previous statin therapy (at least two statins).
Forty patients with documented intolerance to any dose of at least two statins were prospectively enrolled into a protocol (mean age = 65 years; males = 46%, documented CAD = 46%; hypertension = 77%, diabetes = 12%, positive family history of CAD = 62%, smoker = 12%). An initial sample of pitavastain was provided to see if patients could tolerate the therapy. Study investigators compared pre-and post-pitavastatin fasting lipid panel results.
All patients received a trial of pitavastatin 2mg per day. Of these, 27 (68%, 95% CI 54–83%) tolerated the trial and received a long-term prescription to continue on maintenance therapy. Among those able to tolerate pitavastatin, baseline fasting LDL cholesterol was reduced by an average of 34% from 147 ± 27mg/dL to 93 ± 25mg/dL.
These findings suggest that low-dose pitavastatin can be used as an alternative therapy in patients who have been otherwise intolerant to statin therapy. Hollaway and colleagues observed that patients who could best tolerate pitavastatin tended to be “males and those who had no history of coronary artery disease or diabetes.”