Meta-analysis of the comparative efficacy and safety of pitavastatin and atorvastatin in patients with dyslipidaemia

What is known and Objective: Pitavastatin is the latest available statin. It has been shown to be effective in the treatment of dyslipidaemia. This meta-analysis was aimed at evaluating the effects of pitavastatin on lipid profiles in patients with dyslipidaemia compared with atorvastatin. Methods: Clinical trials were identified through electronic searches (MEDLINE, CINAHL, EBM review, and the Cochrane Library) up to January 2011 and historical searches of relevant articles. Studies were included in the meta-analysis if they were (i) randomized controlled trials that evaluated pitavastatin at the recommended dose vs. atorvastatin in patients with dyslipidaemia, (ii) lasting at least 6 weeks, (iii) reporting total cholesterol (TC), LDL-C, HDL-C or triglyceride (TG) levels and (iv) published in English. Treatment effect was estimated with the mean difference in the per cent changes in lipid profiles from baseline to final assessment between pitavastatin and atorvastatin. Results: Seven trials involving 1529 patients were included. Pitavastatin reduced LDL-C level as effectively as atorvastatin (mean difference 0.97%, 95% CI) 0.48% to 2.42%). The reductions in TC and TG levels were also comparable between the two drugs. The mean differences were 1.22% (95% CI) 0.55% to 2.99%) and 2.3% (95% CI) 1.06% to 5.65%), respectively. However, HDL-C levels increased significantly more with pitavastatin than with atorvastatin (mean difference 1.78%, 95% CI 0.20-3.36%, P = 0.03). What is new and Conclusions: Pitavastatin was as effective as atorvastatin in lowering LDL-C, TC and TG levels. Pitavastatin was marginally superior to atorvastatin in increasing HDLC levels.