Inpharma 1558 - 7 Oct 2006 Low-dose pravastatin prevents cardiovascular disease Low-dose pravastatin reduces the risk of coronary heart disease in Japanese patients with hypercholesterolaemia, according to results from the open-label MEGA study. 1 8214 patients with hypercholesterolaemia, aged 40–70 years, were randomised to receive either diet plus pravastatin (n = 3866) or diet alone. * Pravastatin was initiated at a dosage of 10 mg/day; this dosage could be uptitrated to 20 mg/day by the treating physician. During a mean follow-up of 5.3 years, pravastatin recipients had a significantly lower incidence of coronary heart disease, compared with patients in the diet group (hazard ratio 0.67; 95% CI 0.49, 0.91). Over this time, the number needed to treat to prevent one coronary heart disease event was 119 patients. The incidence of myocardial infarction was significantly lower in the pravastatin plus diet group than in the diet group (0.52; 0.29, 0.94). Furthermore, pravastatin treatment was associated with significantly lower incidences of coronary heart disease and cerebral infarction, and of all cardiovascular events, compared with diet alone. In an accompanying editorial, Dr Cesare R Sirtori and Dr Laura Calabresi, from Niguarda Hospital and the University of Milano, Milan, Italy, comment that "the positive outcome of MEGA emphasises the importance of population versus individual approaches, and of social choices for cardiovascular prevention". 2 They also state that the results "probably do not justify a publicly supported distribution of statins - but might, however, encourage direct access by patients to statins". * This study was supported by Sankyo Co., Japan. 1. Nakamura H, et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet 368: 1155-1163, No. 9542, 30 Sep 2006. 2. Sirtori CR, et al. Japan: are statins still good for everybody? Lancet 368: 1135-1136, No. 9542, 30 Sep 2006. 801069230 1 Inpharma 7 Oct 2006 No. 1558 1173-8324/10/1558-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved

Low-dose pravastatin prevents cardiovascular disease

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Inpharma 1558 - 7 Oct 2006

Low-dose pravastatin preventscardiovascular disease

Low-dose pravastatin reduces the risk of coronaryheart disease in Japanese patients withhypercholesterolaemia, according to results from theopen-label MEGA study.1

8214 patients with hypercholesterolaemia, aged40–70 years, were randomised to receive either dietplus pravastatin (n = 3866) or diet alone.* Pravastatinwas initiated at a dosage of 10 mg/day; this dosage couldbe uptitrated to 20 mg/day by the treating physician.

During a mean follow-up of 5.3 years, pravastatinrecipients had a significantly lower incidence ofcoronary heart disease, compared with patients in thediet group (hazard ratio 0.67; 95% CI 0.49, 0.91). Overthis time, the number needed to treat to prevent onecoronary heart disease event was 119 patients. Theincidence of myocardial infarction was significantlylower in the pravastatin plus diet group than in the dietgroup (0.52; 0.29, 0.94). Furthermore, pravastatintreatment was associated with significantly lowerincidences of coronary heart disease and cerebralinfarction, and of all cardiovascular events, comparedwith diet alone.

In an accompanying editorial, Dr Cesare R Sirtori andDr Laura Calabresi, from Niguarda Hospital and theUniversity of Milano, Milan, Italy, comment that "thepositive outcome of MEGA emphasises the importanceof population versus individual approaches, and ofsocial choices for cardiovascular prevention".2 They alsostate that the results "probably do not justify a publiclysupported distribution of statins - but might, however,encourage direct access by patients to statins".* This study was supported by Sankyo Co., Japan.

1. Nakamura H, et al. Primary prevention of cardiovascular disease withpravastatin in Japan (MEGA Study): a prospective randomised controlled trial.Lancet 368: 1155-1163, No. 9542, 30 Sep 2006.

2. Sirtori CR, et al. Japan: are statins still good for everybody? Lancet 368:1135-1136, No. 9542, 30 Sep 2006.

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