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Mevacor

Clinical Pharmacology
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Clinical Pharmacology

MEVACOR was studied in controlled trials in hypercholesterolemic patients with well-controlled non-insulin dependent diabetes mellitus with normal renal function. The effect of MEVACOR on lipids and lipoproteins and the safety profile of MEVACOR were similar to that demonstrated in studies in nondiabetics. MEVACOR had no clinically important effect on glycemic control or on the dose requirement of oral hypoglycemic agents.

Expanded Clinical Evaluation of Lovastatin (EXCEL) Study

MEVACOR was compared to placebo in 8,245 patients with hypercholesterolemia (total-C 240-300 mg/dL [6.2 mmol/L - 7.6 mmol/L], LDL-C > 160 mg/dL [4.1 mmol/L]) in the randomized, double-blind, parallel, 48-week EXCEL study. All changes in the lipid measurements (Table III) in MEVACOR treated patients were dose-related and significantly different from placebo (p 0.001). These results were sustained throughout the study.

TABLE III MEVACOR vs. Placebo (Percent Change from Baseline — Average Values Between Weeks 12 and 48)

DOSAGE N** TOTAL-C
(mean)
LDL-C
(mean)
HDL-C
(mean)
LDL-C/
HDL-C
(mean)
TOTAL-C/
HDL-C
(mean)
TG.
(median)
Placebo 1663 +0.7 +0.4 +2.0 +0.2 +0.6 +4
MEVACOR              
20 mg q.p.m. 1642 - 17 - 24 +6.6 - 27 - 21 - 10
40 mg q.p.m. 1645 - 22 - 30 +7.2 - 34 - 26 - 14
20 mg b.i.d. 1646 - 24 - 34 +8.6 - 38 - 29 - 16
40 mg b.i.d. 1649 - 29 - 40 +9.5 - 44 - 34 - 19
**Patients enrolled

Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS)

The Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS), a double-blind, randomized, placebo-controlled, primary prevention study, demonstrated that treatment with MEVACOR decreased the rate of acute major coronary events (composite endpoint of myocardial infarction, unstable angina, and sudden cardiac death) compared with placebo during a median of 5.1 years of follow-up. Participants were middle-aged and elderly men (ages 45-73) and women (ages 55-73) without symptomatic cardiovascular disease with average to moderately elevated total-C and LDL-C, below average HDL-C, and who were at high risk based on elevated total-C/HDL-C. In addition to age, 63% of the participants had at least one other risk factor (baseline HDL-C < 35 mg/dL, hypertension, family history, smoking and diabetes).

AFCAPS/TexCAPS enrolled 6,605 participants (5,608 men, 997 women) based on the following lipid entry criteria: total-C range of 180-264 mg/dL, LDL-C range of 130-190 mg/dL, HDL-C of ≤ 45 mg/dL for men and ≤ 47 mg/dL for women, and TG of 400 mg/dL. Participants were treated with standard care, including diet, and either MEVACOR 20-40 mg daily (n= 3,304) or placebo (n= 3,301). Approximately 50% of the participants treated with MEVACOR were titrated to 40 mg daily when their LDL-C remained > 110 mg/dL at the 20-mg starting dose.

Brand Name: Mevacor
Generic Name: Lovastatin
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