Efficacy of alternate-day versus everyday dosing of atorvastatin

Abstract

Background:Atorvastatin has a longer duration of action than other hydroxymethylglutaryl coenzyme A reductase inhibitors.Objectives:The objective was to evaluate the efficacy of alternate day vs. daily dosing of atorvastatin for the treatment of hyperlipidemia.Materials and Methods:In this prospective, open label, crossover study, 40 patients with plasma low-density cholesterol (LDL-C) of more than 130 mg/dl and total cholesterol (TC) more than 200 mg/dl were recruited. After baseline tests, they were randomly allocated to two groups. Group A received 20 mg atorvastatin on alternate days and group B received 20 mg atorvastatin daily for 12 weeks. After 4 weeks of washout period, the groups were crossed over to the other treatment regimen for another 12 weeks. Fasting plasma lipid profile and serum alanine transaminase (ALT) and aspartate transaminase (AST) were measured for both groups at 6th, 12th, 16th, 22nd, and 28th weeks. Results were pooled across the periods and data between the two groups were compared using unpaired t-test.Results:Among the 40 enrolled subjects, 38 completed the study. Both treatment regimens significantly reduced LDL-C and TC compared to baseline. There was no statistically significant difference between the two groups in terms of reduction of plasma LDL-C and TC at 6 and 12 weeks of treatment. Both the regimens were well tolerated.Conclusion:Alternate-day treatment with atorvastatin is comparable in efficacy and safety to the established daily treatment regimen, thus being a cost effective alternative.

Efficacy of alternate day versus daily atorvastatin in reduction of low density lipoprotein cholesterol: a prospective, randomized, open labelled, parallel group study

“…In both the groups, a significant reduction in LDL-C was seen but the difference between the two groups was not statistically significant, findings similar to those of Matalka et al, Pramanik et al and Keles et al 6,14,15 Regarding the percentage of the participants achieving LDL-C levels <100 mg/dL, both the groups were comparable. A similar finding was seen in Matalka et al study where 43% patients from alternate day atorvastatin group and 75 % patients from daily atorvastatin group achieved LDL-C levels <100 mg/dL (p>0.05).…”

“…Similar findings had been reported by Pramanik et al where there was 27.14% reduction in TC with alternate day atorvastatin therapy and 29% with daily atorvastatin therapy. 14 Juszczyk et al showed a greater percentage reduction in TC which might be because a higher dose (40 mg) of atorvastatin, used in their study. 8 The safety and tolerability elicited by both regimens in present study were consistent with the studies conducted by Keles et al, Jafari et al and Ghia et al 15,17,18 The adverse events were mild and none of the patients from either group discontinued the study drugs because of it.…”

To compare the efficacy of alternate day versus everyday dosing of atorvastatin in hyperlipidemic rabbits

“…These findings are cohesive with Pramanik S et al, Jafari M et al, Matalka MS, et al and Aghosadeghi K and Zare et al [6][7][8][9] A prospective, open label, crossover study in 40 patients conducted by Pramanik S et al evaluating the efficacy of alternate day atorvastatin versus daily dosing showed that both treatment regimens significantly reduced TC and TG and LDL-C levels as compared to baseline. There was no statistically significant difference between the two groups in terms of reduction of TC, TG and LDL-C at 12 weeks of treatment.…”

Tolerability and effectiveness of every-other-day atorvastatin compared to daily atorvastatin in patients with muscle symptoms: A randomized controlled clinical trial

“…In this study, the mean percentage increase of LDL-cholesterol from baseline to assessment at 6 weeks was significantly higher in those who were on atorvastatin every-other-day as compared to daily atorvastatin group (32.8% vs 1.5%). However, some other studies have shown that every-other-day dosing of atorvastatin is as effective as daily atorvastatin in controlling LDL-cholesterol [ [31] , [32] , [33] ]. Jafari et al conducted a randomized controlled trial in 54 patients and found that there was no difference in LDL-cholesterol level at 6 weeks between those who received atorvastatin 10 mg daily and 10 mg every-other-day [ 31 ].…”