Pitavastatin – a new inhibitor of the HMG-CoA reductase: peculiarities of clinical pharmacology and perspectives of its usage in treatment of cardiovascular diseases.
DOI:
https://doi.org/10.26641/2307-0404.2013.4.20369Keywords:
cardiovascular diseases, atherosclerosis, dyslipidemia, inhibitors of the HMG-CoA reductase, pitavastatin, statinsAbstract
Cardiovascular mortality makes up 66.3 % of the total mortality in Ukraine. Myocardial infarction, stroke, atherosclerosis of peripheral arteries are the diseases caused by atherosclerosis and are prevalent in the mortality structure. One of the most effective means of successful prevention of cardiovascular disease are drugs that reduce the content of atherogenic lipids in the blood. Statins are the first line drugs for the treatment of patients with dyslipidemia and atherosclerosis in accordance with national and international guidelines. The article presents the features of the pharmacokinetics and pharmacodynamics, results of clinical trials and data on the efficacy and safety of a new inhibitor of the HMG-CoA reductase – pitavastatin (Livazo © (Recordati, Italy). Data from several multicenter randomized studies indicate that pitavastatin significantly reduces the level of cholesterol low-density lipoproteins and triglycerides, significantly increases the level of cholesterol high-density lipoproteins after 12 weeks of observation, and contributes to a significant regression of atherosclerotic plaques. It was shown that pitavastatin has a high level of safety and is well tolerated regardless of patients' age and racial origin. Pitavastatin is a new effective inhibitor of HMG -CoA reductase, which has been successfully used in many countries for the dyslipidemia treatment in patients with cardiovascular disease, diabetes, kidney diseases and other comorbid conditions.References
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Morgan RE, Campbell SE, Yu CY et al. Compa¬rison of the safety, tolerability, and pharmacokinetic profile of a single oral dose of pitavastatin 4 mg in adult subjects with severe renal impairment not on hemo¬dialysis versus healthy adult subjects. J Cardiovasc Phar¬macol. 2012;60(1):42-48.
Corsini A, Ceska R. Drug-drug interactions with statins: will pitavastatin overcome the statins' Achilles' heel?. Curr Med Res Opin. 2011;27(8):1551-162.
Inagaki Y, Hunt T, Arana B et al. Drug-drug inter¬action study to assess the effects of multiple-dose pitavastatin on steady-state warfarin in healthy adult volunteers. J Clin Pharmacol. 2011;51(9):1302-09.
Hiro T, Kimura T, Morimoto T et al. Effect of intensive statin therapy on regression of coronary athero¬sclerosis in patients with acute coronary syndrome: a multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus ator¬vastatin (JAPAN-ACS [Japan assessment of pitavastatin and atorvastatin in acute coronary syndrome] study). J Am Coll Cardiol. 2009;54:293-302.
Warita S, Kawasaki M, Tanaka R et al. Effects of pitavastatinon cardiac structure and function and on prevention of atrial fibrillation in elderly hypertensive pa¬tients: a prospective study of 2-years' follow-up. Circ J. 2012;76(12):2755-62.
Han KH, Rha SW, Kang HJ et al. Evaluation of short-term safety and efficacy of HMG-CoA reductase inhibitors in hypercholesterolemic patients with elevated serum alanine transaminase concentrations: PITCH study (PITavastatin versus atorvastatin to evaluate the effect on patients with hypercholesterolemia and mild to moderate hepatic damage). J Clin Lipidol. 2012;6(4):340-51.
Kishida K, Funahashi T, Shimomura I. Impor¬tance of Assessing the Effect of Statins on the Function of High- Density Lipoproteins on Coronary Plaque. Cardio¬vascular & Haematological Disorders-Drug Targets. 2012; 12:28-34.
Kotseva K, Wood D, De BG. EURROASPIRE III: a survey on the lifestyle, risk factors and use of car¬dio¬protective drug therapies in coronary patients from 22 Eu¬ropean countries. Eur. J. Cardivasc. Prev Rehabil. 2009;16:121-37.
Waters DD, Brotons C, Chiang CW et al. Lipid treatment assessment project 2: a multinational survey to evaluate the proportion of patients achieving low-density lipoprotein cholesterol goals. Circulation. 2009;120:28-34.
Masana L. Pitavastatin in cardiometabolic di¬sease: therapeutic profile. Cardiovasc Diabetol. 2013;12 (1):2.
Fujino H, Yamada I, Shimada S et al. Metabolic fate of pitavastatin (NK-104), a new inhibitor of 3-hydro¬xy-3-methyl-glutaryl coenzyme A reductase. Effects on drug-metabolizing systems in rats and humans. Arz¬neimitt¬elforschung. 2002;12:745–53.
Mukhtar RY, Reid J, Reckless JP. Pitavastatin. Int J Clin Pract. 2005;12:239–52.
Yokote K, Bujo H, Hanaoka H et al. Multicenter collaborative randomized parallel group comparative stu¬dy of pitavastatin and atorvastatin in Japanese hypercho¬lestero¬lemic patients: collaborative study on hypercho¬lesterolemia drug intervention and their benefits for atherosclerosis prevention (CHIBA study). Athero¬scle¬ro¬sis. 2008;201(2):345-52.
Neuvonen PJ, Niemi M, Backman JT. Drug inter¬actions with lipid-lowering drugs: mechanisms and clini¬cal relevance. Clin Pharmacol Ther. 2006;12:565–81.
Teramato T, Shimano H, Yokote K et al. New evi¬dence on pitavastatin: efficacy and safety in clinical studies. Expert Opin Pharmacother. 2010;11(5):817-28.
Jung JA, Noh YH, Jin S et al. Pharmacokinetic interaction between pitavastatin and valsartan: a ran¬domized, open-labeled crossover study in healthy male Korean volunteers. Clin Ther. 2012;34(4):958-65.
Aoki T, Nishimura H, Nakagawa S et al. Pharma¬cological profile of a novel synthetic inhibitor of 3-hydroxy-3-methylglutaryl-coenzyme A reductase. Arznei¬mittelforschung. 1997;12:904–9.
Stender S, Budinski D, Gosho M et al. Pita¬vas¬tatin shows greater lipid-lowering efficacy over 12 weeks than pravastatin in elderly patients with primary hyper¬cholesterolaemia or combined (mixed) dyslipidaemia. Eur J Prev Cardiol. 2013;20(1):40-53.
Morikawa S, Umetani M, Nakagawa S et al. Re¬lative induction of mRNA for HMG CoA reductase and LDL receptor by five different HMG-CoA reductase in¬hibitors in cultured human cells. J Atheroscler Thromb. 2000;12:138–44.
RxList. Livalo (pitavastatin) drug – clinical pharma¬co¬logy / [Electronic resource]. Access mode: http:// www.rxlist.com/livalo-drug/clinical-pharmacology.htm
Mao Y, Yu JM, Zhan YQ et al. Safety and efficacy of pitavastatin in patients with hypercho¬les¬terolemia: a multicenter study. Zhonghua Yi Xue Za Zhi. 2012;92(14):968-73.
Saito Y. Pitavastatin: an overview. Atheroscler SuppI. 2011;12:272–76.
Stender S, Budinski D, Hounslow N. Pita¬vas¬tatin demonstrates long-term efficacy, safety and tolera¬bility in elderly patients with primary hypercho¬leste¬rolaemia or combined (mixed) dyslipidaemia. Eur. J Prev. Cardiol. 2013;20(1):29-39.
Mao Y, Yu JM, Zhang F et al. The effect of pitavastatin on blood glucose and its efficacy in diabetic patients with hypercholesterolemia. Zhonghua Nei Ke Za Zhi. 2012;51(7):508-12.
Warrington S, Nagakawa S, Hounslow N. Com¬parison of the pharmacokinetics of pitavastatin by for¬mulation and ethnic group: an open-label, single-dose, two-way crossover pharmacokinetic study in healthy Cauca¬sian and Japanese men. Clin Drug Investig. 2011;31(10):735-43.
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