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June 1, 1993The Journal of Clinical Pharmacology

Effects of One Year of Treatment with Pravastatin, an HMG‐CoA Reductase Inhibitor, on Lipoprotein a

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Why the study?

Does pravastatin reduce Lipoprotein a concentrations in patients with elevated LDL-C?

Population

125 men and women with mean LDL-C ≥150 mg/dL and mean plasma triglycerides <250 mg/dL, selected from a phase…

Comparison

Pravastatin 10, 20, or 40 mg daily for 12 weeks… vs Placebo for 12 weeks.

Design

RCT, double-blind

Follow-up

48 weeks

Authors

DHDonald B. HunninghakeESEvan A. SteinMMMargot J. Mellies

Discussion

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Overview

Pravastatin can be used for LDL-C lowering without Lp(a) benefit or harm; confirms statins lack meaningful effect on this risk factor.

Key Points

  • To assess the effects of one year of pravastatin therapy on plasma lipoprotein(a) concentrations in patients with primary hypercholesterolemia.
  • Evaluated a cohort of 125 adults with baseline LDL-C ≥ 150 mg/dL and triglycerides < 250 mg/dL selected from a phase 2 dose-ranging trial.
  • Administered placebo (N=46) or pravastatin 10, 20, or 40 mg daily (N=79) during a 12-week double-blind phase, followed by a 48-week open-label pravastatin extension in the 79 pravastatin-treated patients.
  • During the 12-week double-blind phase, lipoprotein(a) changed by -4.6% with placebo and -0.4% with pravastatin, reflecting a non-significant net difference.
  • At week 48 of pravastatin treatment, lipoprotein(a) showed a non-significant 2.4% increase overall and an insignificant decrease in 19 patients with baseline levels > 30 mg/dL.
  • Pravastatin significantly improved overall lipid profiles at week 48 (P < 0.01), decreasing LDL-C (-33.6%), total cholesterol (-25.6%), triglycerides (-19.9%), and apolipoprotein B (-33.0%), while increasing HDL-C (+7.0%) and apolipoprotein A-I (+13.3%).

Structured PICO

Does pravastatin reduce Lipoprotein a concentrations in patients with elevated LDL-C?

P
Population
125 men and women with mean LDL-C ≥150 mg/dL and mean plasma triglycerides <250 mg/dL, selected from a phase 2 dose-ranging study.
I
Intervention
Pravastatin 10, 20, or 40 mg daily for 12 weeks (double-blind) followed by 48 weeks open-label.
C
Comparator
Placebo for 12 weeks.
O
Outcome
Change in Lipoprotein a [Lp(a)] concentrations at 12 weeks and 48 weeks.surrogate

Pravastatin effectively lowers LDL-C and total cholesterol but does not significantly alter Lipoprotein a concentrations.

Cite This Study

Hunninghake et al. (1993) studied this question.

synapsesocial.com/papers/6a19acc33f3ec013f0dee883https://doi.org/10.1002/j.1552-4604.1993.tb04706.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Apolipoprotein(a) polymorphism predicts the increase of Lp(a) by pravastatin in patients with familial hypercholesterolaemia treated with bile acid sequestration1993 · 32 citations
  2. 2Pravastatin: An Antithrombotic Effect Independent of the Cholesterol-lowering Effect2000 · 103 citations
  3. 3Pravastatin once daily in hypercholesterolaemia: a U.K. study1993 · 2 citations
  4. 4Statins—Their Effect on Lipoprotein(a) Levels2025 · 7 citations
  5. 5Effects of Pravastatin Administration for 12 Months on Serum Lipid Levels in Aged Patients with Hypercholesterolemia.1994 · 1 citations