Application of pitavastatin in actual clinical practice. Optimal ratio of benefits and risks
In the treatment of dislipidemij the most effective and safest class of drugs remain statins. Republic of Crimea has accumulated clinical experience using the drug pitavastatin, which was registered in Ukraine in the year 2013 under the trade name Livazo (Recordati, Italy). Aim of article: to assess the dynamics of lipid spectrum in the appointment of pitavastatina among patients with high and very high cardiovascular risk, who have not reached the target levels of low density lipoprotein cholesterol treatment with generic analogs of atorvastatin and rosuvastatin. Materials and methods: 29 patients (15 men and 14 women) between the ages of 35 to 65 years with hyperlipidaemia, high or very high absolute risk 10-year coronary death were examined. 12 patients included in the study, was diagnosed of hypertension, 8-ischemic heart disease, stable stenocardia voltage, 9-ischemic heart disease, cardiosclerosis postmyocardial infarction. All participants have identified the Dyslipidemia, with levels of total cholesterol (OCHS) in plasma > 5, 5 mmol/l, CHOLESTEROL LDL > 3 mmol/l Selected patients included in the study had been taking the generic equivalent of atorvastatin dose of 20-40 mg or rosuvastatin at a dose of 10-20 mg. for 2 or more months. The main criterion for inclusion in the study was the absence of a target LDL CHOLESTEROL level amid maximum dose generic portable analogues of atorvastatin and rosuvastatin. Because it was inabile to achieve target levels of lipids, these drugs have been cancelled and Livazo at a dose of 2 mg or 4 mg for 8 weeks was appointed. Initial dose depended on the initial level of LDL CHOLESTEROL. The starting dose was 2 mg. The patients whose LDL cholesterol levels should be decreased by more than 50% took 4 mg dose. Before and 2 months after the start of treatment the levels of total cholesterol, LDL CHOLESTEROL, high density lipoprotein cholesterol, triglycerides. Results and discussion: In 8 weeks after the start of the pitavastatin taking, the best lowering effect was obtained in reducing levels of LDL CHOLESTEROL, high density lipoprotein cholesterol, Pitavastatin also provides a constant and significant increase in the level of HDL CHOLESTEROL among patients with low baseline levels and provides long-lasting positive impact on the content of others atherogenic lipid and including triglycerides. When assessing the safety of the drug side effects is not registered, the transaminase level statistically significantly unchanged, preparation is not required. Thus, pitavastatin is effective in achieving the target indicators of blood lipid spectrum among patients with high and very high cardiovascular risk by a statistically significant reduction in the level of OCHS, TG and LDL CHOLESTEROL, raising HDL CHOLESTEROL. Insufficient hypolipidemic effect of treatment with generic analogs of atorvastatin and rosuvastatin further pitavastatin treatment has allowed to achieve target levels of LDL CHOLESTEROL (79.3%) among 23 patients. use of pitavastatin in the study had not been accompanied by a clinically significant side effects.