Efficacy and safety of cerivastatin in primary hypercholesterolemia: A long term comparative titration study with simvastatin

OBJECTIVE: To compare cerivastatin with simvastatin in their long term safety and efficacy in reducing low density lipoprotein cholesterol (LDL-C). DESIGN: Multicentre, randomized, double-blind, parallel group study. SETTING: Thirteen Canadian centres. PATIENTS AND METHODS: A total of 387 patients with primary hypercholesterolemia received treatment with either cerivastatin (0.05 to 0.3 mg/day) or simvastatin (5 to 40 mg/day) to achieve plasma LDL-C levels below 3.36 mmol/L (130 mg/dL) for an initial 32-week dose-titration phase and a subsequent 72-week extension phase. MAIN RESULTS: Cerivastatin and simvastatin produced clinically significant reductions in LDL C of 28.4% and 35.4%, respectively, at the end point for the 32-week study, and reductions of 32.8% and 35.0%, respectively, at the end of the extension phase of the study. Response rates (a greater than 15% drop in LDL-C) were comparable for the two treatments (88.9% cerivastatin versus 93.2% simvastatin) at the 32-week end point. Response rates were 100% for both treatments at the end of the 72-week extension phase. Both treatments also reduced total cholesterol, apolipoprotein B and very low density lipoprotein cholesterol levels. Cerivastatin and simvastatin increased HDL-C levels significantly by 8.8% and 11.0%, respectively, at the end point for the 32-week study, and by 8.6% and 12.1%, respectively, at the end of the extension phase of the study. Treatments were well tolerated, and the incidence of adverse effects was similar in both groups. CONCLUSIONS: This forced titration study demonstrates that cerivastatin, given once daily at doses up to 0.3 mg/day, is effective and well tolerated. The results of this study support further investigation of higher doses of cerivastatin given the excellent safety profile at doses up to 0.3 mg.