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一项关于匹伐他汀疗效和安全性的多中心前瞻性基于医院的队列研究

A Multicenter Prospective Hospital-based Cohort Study on the Efficacy and Safety of Pitavastatin.

机构信息

Department of Internal Medicine, College of Medicine, United Arab Emirates University (UAEU), Al Ain, United Arab Emirates.

Clinical Pharmacy Program, Pharmacy College, Al Ain University, Abu Dhabi Campus,, United Arab Emirates.

出版信息

Curr Diabetes Rev. 2021;17(7):e122820189541. doi: 10.2174/1573399817666201228164243.

Abstract

AIMS

We aim to investigate the efficacy and safety of pitavastatin 4 mg in a population of people living in the United Arab Emirates (UAE).

BACKGROUND

Pitavastatin is a member of the HMG-CoA reductase inhibitors family which was approved for use in adult subjects with primary hyperlipidemia or mixed dyslipidemia. To date, no published studies have assessed the efficacy and safety of pitavastatin in the United Arab Emirates.

OBJECTIVE

The main objective of the current study was to investigate the efficacy and safety of pitavastatin in subjects with dyslipidemia for the primary prevention of cardiovascular diseases based on total cardiovascular risk.

METHODS

This was a multicentre (four private hospitals) prospective cohort study to analyze data on the use of pitavastatin for dyslipidemia in adult outpatients in Abu Dhabi and Dubai, United Arab Emirates. We have followed up the clinical profiles of subjects in four hospitals for six-weeks during the period from June 2015 to June 2017. Efficacy was based on the evaluation of the mean (± standard deviation) change in low-density lipoprotein cholesterol between baseline and week six after the initiation of pitavastatin therapy. Safety was reported with respect to the incidence of adverse events occurring with the use of pitavastatin and the development of new-onset diabetes.

RESULTS

A total of 400 subjects who were receiving pitavastatin 4 mg were included. The mean age of subjects was 50.7 ±10.8 years; of these, 79.0% were males. At the baseline, the mean level of total cholesterol was 185.4 ±41.5 mg/dL, low density lipoprotein was 154.9 ±48.55 mg/dL, high- -density lipoprotein cholesterol was 40.5 ±11.23 mg/dL and fasting blood glucose was 115.0 (±16.63) mg/dl. At the end of six weeks, low density lipoprotein levels significantly decreased to 112.09 ±41.90 mg/dl (standard mean difference (SMD) (-42.8%), 95% CI: -42.88 [-49.17 to -36.58] mg/dl, P <0.001), while high density lipoprotein levels improved (SMD, 95% CI: 1.77% [0.25 to 3.28] mg/dl, P <0.022). There were 55 subjects (13.7%) who reported various adverse events such as myalgia (7.5%), sleep disorders (2.5%), and myopathy (2.2%). Furthermore, 4 (1.0%) have had developed new-onset diabetes post-six-weeks of initiation of pitavastatin therapy.

CONCLUSION

Pitavastatin 4 mg showed robust efficacy in reducing LDL-C levels and improving HDL-C levels in subjects with dyslipidemia. The use of pitavastatin was associated with a low discontinuation rate, fewer adverse events, and very limited cases of new-onset diabetes.

摘要

目的

我们旨在研究在阿拉伯联合酋长国(阿联酋)人群中,匹伐他汀 4 毫克的疗效和安全性。

背景

匹伐他汀是 HMG-CoA 还原酶抑制剂家族的成员,已获准用于原发性高脂血症或混合性血脂异常的成年患者。迄今为止,尚无研究评估匹伐他汀在阿联酋的疗效和安全性。

目的

本研究的主要目的是根据总体心血管风险,研究匹伐他汀在血脂异常患者中的疗效和安全性,用于心血管疾病的一级预防。

方法

这是一项多中心(四家私立医院)前瞻性队列研究,分析了 2015 年 6 月至 2017 年 6 月期间在阿布扎比和迪拜的四家医院中成年门诊患者使用匹伐他汀治疗血脂异常的数据。我们对 4 家医院的患者的临床特征进行了为期 6 周的随访。疗效基于启动匹伐他汀治疗后基线至第 6 周时低密度脂蛋白胆固醇的平均(±标准差)变化来评估。安全性根据使用匹伐他汀治疗时发生的不良反应发生率和新发糖尿病的发生情况来报告。

结果

共纳入 400 名接受匹伐他汀 4 毫克治疗的患者。患者的平均年龄为 50.7 ±10.8 岁,其中 79.0%为男性。基线时,总胆固醇平均水平为 185.4 ±41.5mg/dL,低密度脂蛋白为 154.9 ±48.55mg/dL,高密度脂蛋白胆固醇为 40.5 ±11.23mg/dL,空腹血糖为 115.0(±16.63)mg/dl。6 周后,低密度脂蛋白水平显著降低至 112.09 ±41.90mg/dl(标准平均差值(SMD)(-42.8%),95%置信区间:-42.88[-49.17 至-36.58]mg/dl,P<0.001),而高密度脂蛋白水平得到改善(SMD,95%置信区间:1.77%[0.25 至 3.28]mg/dl,P<0.022)。有 55 名患者(13.7%)报告了各种不良反应,如肌痛(7.5%)、睡眠障碍(2.5%)和肌病(2.2%)。此外,4 名患者(1.0%)在开始匹伐他汀治疗后 6 周出现新发糖尿病。

结论

匹伐他汀 4 毫克在降低血脂异常患者的 LDL-C 水平和提高 HDL-C 水平方面显示出强大的疗效。匹伐他汀的使用与较低的停药率、较少的不良反应和非常有限的新发糖尿病病例相关。

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