3/28/2018 Lipid lowering efficacy of atorvastatin.

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Cochrane Database Syst Rev. 2012 Dec 12;12:CD008226. doi: 10.1002/14651858.CD008226.pub2.

Lipid lowering efficacy of atorvastatin.

Adams SP1, Tsang M, Wright JM.

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Update in
Lipid-lowering efficacy of atorvastatin. [Cochrane Database Syst Rev. 2015]

Abstract
BACKGROUND: Atorvastatin is one of the most widely prescribed drugs and the most widely
prescribed statin in the world. It is therefore important to know the dose-related magnitude of
effect of atorvastatin on blood lipids.
OBJECTIVES: To quantify the dose-related effects of atorvastatin on blood lipids and withdrawals
due to adverse effects (WDAE).
SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials
(CENTRAL) on The Cochrane Library Issue 4, 2011, MEDLINE (1966 to November 2011),
EMBASE (1980 to November 2011), ISI Web of Science (1899 to November 2011) and BIOSIS
Previews (1969 to November 2011). No language restrictions were applied.
SELECTION CRITERIA: Randomised controlled and uncontrolled before-and-after trials
evaluating the dose response of different fixed doses of atorvastatin on blood lipids over a
duration of 3 to 12 weeks.
DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality
and extracted data. WDAE information was collected from the placebo-controlled trials.
MAIN RESULTS: Two hundred fifty-four trials evaluated the dose-related efficacy of atorvastatin in
33,505 participants. Log dose-response data revealed linear dose-related effects on blood total
cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides. Combining all the trials
using the generic inverse variance fixed-effect model for doses of 10 to 80 mg/day resulted in
decreases of 36% to 53% for LDL-cholesterol. There was no significant dose-related effects of
atorvastatin on blood high-density lipoprotein (HDL)-cholesterol. WDAE were not statistically
different between atorvastatin and placebo for these short-term trials (risk ratio 0.99; 95%
confidence interval 0.68 to 1.45).
AUTHORS' CONCLUSIONS: Blood total cholesterol, LDL-cholesterol and triglyceride lowering
effect of atorvastatin was dependent on dose. Log dose-response data was linear over the
commonly prescribed dose range. Manufacturer-recommended atorvastatin doses of 10 to 80
mg/day resulted in 36% to 53% decreases of LDL-cholesterol. The review did not provide a good
estimate of the incidence of harms associated with atorvastatin because of the short duration of
the trials and the lack of reporting of adverse effects in 37% of the placebo-controlled trials.

https://www.ncbi.nlm.nih.gov/pubmed/23235655 1/2
3/28/2018 Lipid lowering efficacy of atorvastatin. - PubMed - NCBI

Comment in
Convincing evidence from controlled and uncontrolled studies on the lipid-lowering effect of a statin.
[Cochrane Database Syst Rev. 2012]

PMID: 23235655 DOI: 10.1002/14651858.CD008226.pub2

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https://www.ncbi.nlm.nih.gov/pubmed/23235655 2/2