Vorteile von atorvastatin in der pharmakotherapie der hypercholesterinämie

In patients with hypercholesterolemia basic therapeutic measures such as a change in diet and more physical activity are by themselves often not sufficient to lower elevated lipid levels. Thus pharmacotherapy is necessary. Over the past few years, statins have established themselves as the gold standard in the treatment of hypercholesterolemia and therefore in the prevention of fatal or non-fatal cardiovascular or cerebrovascular events such as myocardial infarction or stroke. Statins are a heterogeneous class of individual substances which differ with regard to their pharmacological as well as therapeutic properties. Atorvastatin has an exceptional position within the statin group. Even at the initial dose of 10 mg, atorvastatin was shown to have positive effects on clinically relevant endpoints. Moreover, atorvastatin acts faster and more effectively than other statins. Atorvastatin was found to be superior in several direct comparative trials comparing atorvastatin and pravastatin or simvastatin. In addition to statins, other lipid-lowering agents are used in Germany such as clofibrinic acid and other agents from the clofibrate group as well as anion-exchange resins. However, these drugs are playing an increasingly insignificant role. In contrast to the well-studied statins, there are no endpoint studies for the cholesterol absorption inhibitor ezetimibe with regard to its effect on atherosclerosis progression or clinically relevant endpoints such as morbidity and mortality. Also at this point it is difficult to know how ezetimibe will fare with regard to long-term safety. Thus statins continue to be considered the gold standard. Evidence shows that within the statin group atorvastatin has an exceptional position, which was also demonstrated in direct comparative trials with other statins.