Effects of Different Forms of Statins on Lipid Profile in Hyperlipidemic Patients

Background and Objective: Statins are the cornerstone of dyslipidemia treatment. This class of drugs decreases all lipids, particularly LDL-C and non-HDL-C and consequently the risk of cardiovascular events. Different trials have, frequently, compared the effect of two statins, while very few studies have directly compared three statins in the same study. The aim of this trial was to evaluate the lipids-lowering effect of atorvastatin, rosuvastatin and pitavastatin, at moderate doses, in a head-to-head comparison, in patients with dyslipidemia. Materials and Methods: The current study was a prospective, randomized, open-label, parallel-group study with blinded endpoints (PROBE design) involving 221 patients. After clinical examination, patients were randomized to atorvastatin (20 mg dL–1), rosuvastatin (10 mg dL–1) or pitavastatin (2 mg dL–1) and followed for 6 months. The primary endpoint of this trial was the change of lipids from baseline. Secondary endpoints included: The rate of subjects with LDL-C reduction >30% and 50% and the lowering effect on non-HDL-C. Results: At the end of this study atorvastatin, rosuvastatin and pitavastatin significantly (p<0.001) decreased plasma levels of lipids, compared with baseline values: (TC -30.1, - 39.1 and -26.8%), LDL-C (-39.1, -40.7 and -38.2%), TG (- 20.5, -17.6 and -13.4%), non-HDL-C (-36.4, -37.1 and -33.4%). No statistically significant difference was obtained between statins at the end of treatment. Differently from atorvastatin and rosuvastatin, pitavastatin increased the level of HDL (1.9%). Conclusion: The lipid-lowering efficacy of atorvastatin, rosuvastatin and pitavastatin is not statistically different, except for the HDL-C.