Step 5: Assess Response to Therapy
ÎRepeat lipid and LDL particle number tests 3 months after starting therapy.
ÎIf not at lipid and LDL particle number goal (measured by apoB or NMR), modify therapy and repeat laboratory tests in 3 months.
ÎModify therapy and repeat laboratory testing every 3 months until goal values for lipid and LDL particle number are achieved.
ÎOnce at goal, continue therapy and repeat laboratory tests in 1 year.
Table 6. Doses of Currently Available Statins Required to Attain an Approximate 30% to 40% Reduction of
Drug
Atorvastatin Lipitor®
Fluvastatin Lescol®
Lovastatin Mevacor®
Pitavastatin Livalo®
Pravastatin Pravachol®
Rosuvastatin Crestor®
Simvastatin Zocor®
a b c , generics , generics , generics
LDL-C Levels (Standard Doses)10, a Dose (mg/day)
, generics 10b 40-80b 40b 1-4 40b 5-10c 20-40b
LDL-C Reduction (%) 39
25-35 31 31-44 34 39-45 35-41
Estimated LDL-C reductions were obtained from US Food and Drug Administration package inserts for each drug.
For rosuvastatin, doses available up to 40 mg, the efficacy for 5 mg is estimated by subtracting 6% from the Food and Drug Administration-reported efficacy at 10 mg.
All of these are available at doses up to 80 mg. For every doubling of the dose above standard dose, an approximate 6% decrease in LDL-C level can be obtained.
13
