Effects of simvastatin, an HMG‐CoA reductase inhibitor, in patients with hypertriglyceridemia

Isaacsohn, Jonathan L.; Hunninghake, Donald B.; Schrott, Helmut G.; Dujovne, Carlos A.; Knopp, Robert H.; Weiss, Stuart; Bays, Harold; Crouse, John R.; Davidson, Michael; Keilson, Leonard; McKenney, James M.; Korenman, Stanley G.; Dobs, Adrian S.; Stein, Evan A.; Krauss, Ronald M.; Maccubbin, Darbie; Cho, Meehyung; Plotkin, D.; Mitchel, Yale

doi:10.1002/clc.4960260105

Cited by 27 publications

(10 citation statements)

References 24 publications

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“…Results from prior studies in subjects with mixed dyslipidemia suggest that each doubling of the dose of simvastatin increases the non-HDL-C response by 5% to 6%. [18][19][20] In the present study, increasing the simvastatin dose from 20 to 80 mg resulted in an additional 10.2% reduction in non-HDL-C compared to P-OM3 1 simvastatin 20 mg (251.0% vs. 240.8%), which is consistent with the anticipated effect. 9,10,14,21,22 Moreover, adding P-OM3 to simvastatin 20 mg resulted in further non-HDL-C lowering compared to simvastatin 20 mg 1 placebo (240.8% vs. 234.9%), suggesting that the effect of adding P-OM3 on non-HDL-C is similar to that observed with each doubling of the simvastatin dose.…”

Section: Discussionsupporting

confidence: 93%

“…9,10,14,21,22 Moreover, adding P-OM3 to simvastatin 20 mg resulted in further non-HDL-C lowering compared to simvastatin 20 mg 1 placebo (240.8% vs. 234.9%), suggesting that the effect of adding P-OM3 on non-HDL-C is similar to that observed with each doubling of the simvastatin dose. [18][19][20] Statins and omega-3 fatty acids affect lipids through distinct mechanisms. P-OM3 primarily reduces the number and triglyceride content of VLDL particles secreted by the liver.…”

Section: Discussionmentioning

confidence: 99%

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Prescription omega-3 acid ethyl esters plus simvastatin 20 and 80 mg: effects in mixed dyslipidemia

Maki

Lubin

Reeves

et al. 2009

Journal of Clinical Lipidology

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Prescription omega-3 acid ethyl esters plus simvastatin 20 and 80 mg: effects in mixed dyslipidemia

Maki

Lubin

Reeves

et al. 2009

Journal of Clinical Lipidology

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“…Table 3 summarizes the range of initial percentage change in non-HDL-C reported in 39 of the 51 trials. 7 –41,52 –55 The percentage reduction achieved by statins, fibric acid derivatives, and ezetimibe monotherapy was similar to what has been demonstrated for LDL-C lowering with these same agents. 1 Table 4 summarizes the range of additional percentage change in non-HDL-C reported in the 12 remaining trials.…”

Section: Resultssupporting

confidence: 64%

Relative Efficacy of Antilipemic Agents in Non–High-Density Lipoprotein Cholesterol Reduction

Santee

Lindsey

Pace

2012

Journal of Pharmacy Practice

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The investigators sought to summarize the percentage reduction in non–high-density lipoprotein cholesterol (non-HDL-C) achieved with various antilipemic regimens and to determine whether certain antilipemic regimens have been proven more effective in lowering non-HDL-C. A search of MEDLINE, International Pharmaceutical Abstracts, and Iowa Drug Information Service Database from 1970 to May 2011 was performed. Criteria were used to exclude studies not published in English, studies with methodology limitations, and studies with variables that may affect efficacy beyond the antilipemic agent administered. Only randomized, controlled trials comparing medications approved by the Food and Drug Administration were reviewed to determine whether significant differences in percentage reduction in non-HDL-C had been observed between different medication regimens. A total of 51 trials reported data that could be used to determine the range of percentage reduction in non-HDL-C achieved by select antilipemic regimens. Of these 51 trials, 38 provided head-to-head comparisons of antilipemic regimens. Rosuvastatin and atorvastatin are the most potent 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in lowering non-HDL-C. Adding ezetimibe, fibric acid derivatives, and omega-3 fatty acids to antilipemic monotherapy may result in further reduction in non-HDL-C. Subjects with certain characteristics (eg, nonwhite) were not prevalent in these studies.

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“…4,26 This consideration is substantiated by the current trial in which increasing the atorvastatin dosage from 10 to 20 mg/d resulted in further lowering of the median non-HDL-C level by 5.3% and by 7.3% when the atorvastatin dosage was increased from 20 to 40 mg/d. Finally, although increasing the statin dose may further reduce LDL-C levels (accounting for most of its non-HDL-C-lowering effects), it may have only a modest effect on other lipid parameters that potentially influence CHD risk, such as triglyceride, VLDL-C, and remnant-like particle cholesterol levels.…”

mentioning

confidence: 84%

Effects of Prescription Omega-3-Acid Ethyl Esters on Non—High-Density Lipoprotein Cholesterol When Coadministered With Escalating Doses of Atorvastatin

Bays

McKenney

Maki

et al. 2010

Mayo Clinic Proceedings

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Objective: To evaluate the effects of prescription omega-3-acid ethyl esters on non-high-density lipoprotein cholesterol (HDL-C) levels in atorvastatin-treated patients with elevated non-HDL-C and triglyceride levels. Results: Prescription omega-3-acid ethyl esters plus atorvastatin, 10, 20, and 40 mg/d, reduced median non-HDL-C levels by 40.2% vs 33.7% (P<.001), 46.9% vs 39.0% (P<.001), and 50.4% vs 46.3% (P<.001) compared with placebo plus the same doses of atorvastatin at the end of 8, 12, and 16 weeks, respectively. Prescription omega-3-acid ethyl esters plus atorvastatin also reduced median total cholesterol, triglyceride, and very low-density lipoprotein cholesterol levels and increased HDL-C levels to a significantly greater extent than placebo plus atorvastatin. Percent changes from baseline low-density lipoprotein-cholesterol, apolipoprotein A-I, and apolipoprotein B levels were not significantly different between groups at the end of the study.cOnclusiOn: Prescription omega-3-acid ethyl esters plus atorvastatin produced significant improvements in non-HDL-C and other lipid parameters in patients with elevated non-HDL-C and triglyceride levels.Mayo Clin Proc. 2010;85(2):122-128 ANOVA = analysis of variance; apo = apolipoprotein; CHD = coronary heart disease; HDL-C = high-density lipoprotein cholesterol; LDL-C = low-density lipoprotein cholesterol; P-OM3 = prescription omega-3-acid ethyl esters; TC = total cholesterol; VLDL = very low-density lipoprotein; VLDL-C = VLDL-cholesterol

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Effects of simvastatin, an HMG‐CoA reductase inhibitor, in patients with hypertriglyceridemia

Cited by 27 publications

References 24 publications

Prescription omega-3 acid ethyl esters plus simvastatin 20 and 80 mg: effects in mixed dyslipidemia

Prescription omega-3 acid ethyl esters plus simvastatin 20 and 80 mg: effects in mixed dyslipidemia

Relative Efficacy of Antilipemic Agents in Non–High-Density Lipoprotein Cholesterol Reduction

Effects of Prescription Omega-3-Acid Ethyl Esters on Non—High-Density Lipoprotein Cholesterol When Coadministered With Escalating Doses of Atorvastatin

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