Bezafibrate and simvastatin (MK-733) in the treatment of primary hypercholesterolaemia
Smith, D.H.; Neutel, J.M.; Jankelow, D.; Myburgh, D.P.
South African Medical Journal 77(10): 500-503
1990
ISSN/ISBN: 0256-9574 PMID: 2188379 Document Number: 358808
Simvastatin, a new 3-hydroxy-3-methylglutaryl co-enzyme A reductase inhibitor, was compared to bezafibrate, a fibric acid derivative, in an open cross-over placebo-controlled study. Bezafibrate was administered as a 200 mg dose 3 times daily, while simvastatin dosage ranged from 10 mg to 40 mg once daily at night. Bezafibrate produced a non-significant 13,1% (P = 0,113) decrease in total cholesterol (TC), a 20,7% (P < 0,05) decrease in low-denity lipoprotein cholesterol (LDL-C), an increase of 26,5% (P < 0,01) in high-density lipoprotein cholesterol (HDL-C) and an improvement in the HDL:LDL ratio of 77,3% (P < 0,01). Simvastatin 10 mg and 20 mg daily reduced TC by 18,6% and 22,6%, respectively, and LDL-C by 23,9% and 28,6%, respectively (P < 0,01), while no significant increase was noted in HDL-C. Simvastatin 40 mg daily reduced TC and LDL-C by 27,1% and 37,6%, respectively (P < 0,01), increased HDL-C by 32,0% (P < 0,05) and improved on the HDL:LDL ratio by 130,8% (P < 0,01). This showed improvements over bezafibrate of 13,5% for TC, 18,9% for LDL-C, 6,0% for HDL-C and 55,8% for HDL:LDL ratio. It was concluded that simvastatin was well tolerated and had significant hypocholesterolaemic effects when taken once daily.