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Meta-Analysis
. 2023 Sep 18;9(9):CD013673.
doi: 10.1002/14651858.CD013673.pub2.

Pravastatin for lowering lipids

Stephen P Adams #  1 , Nima Alaeiilkhchi #  2 , Sara Tasnim  1 , James M Wright  1
Affiliations
Meta-Analysis

Pravastatin for lowering lipids

Stephen P Adams et al. Cochrane Database Syst Rev. .

Abstract

Background: A detailed summary and meta-analysis of the dose-related effect of pravastatin on lipids is not available.

Objectives: Primary objective To assess the pharmacology of pravastatin by characterizing the dose-related effect and variability of the effect of pravastatin on the surrogate marker: low-density lipoprotein (LDL cholesterol). The effect of pravastatin on morbidity and mortality is not the objective of this systematic review. Secondary objectives • To assess the dose-related effect and variability of effect of pravastatin on the following surrogate markers: total cholesterol; high-density lipoprotein (HDL cholesterol); and triglycerides. • To assess the effect of pravastatin on withdrawals due to adverse effects.

Search methods: The Cochrane Hypertension Information Specialist searched the following databases for randomized controlled trials (RCTs) up to September 2021: CENTRAL (2021, Issue 8), Ovid MEDLINE, Ovid Embase, Bireme LILACS, the WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov. We also contacted authors of relevant papers regarding further published and unpublished work. The searches had no language restrictions.

Selection criteria: Randomized placebo-controlled trials evaluating the dose response of different fixed doses of pravastatin on blood lipids over a duration of three to 12 weeks in participants of any age with and without evidence of cardiovascular disease.

Data collection and analysis: Two review authors independently assessed eligibility criteria for studies to be included, and extracted data. We entered lipid data from placebo-controlled trials into Review Manager 5 as continuous data and withdrawal due to adverse effects (WDAEs) data as dichotomous data. We searched for WDAEs information from all trials. We assessed all trials using Cochrane's risk of bias tool under the categories of sequence generation, allocation concealment, blinding, incomplete outcome data, selective reporting, and other potential biases.

Main results: Sixty-four RCTs evaluated the dose-related efficacy of pravastatin in 9771 participants. The participants were of any age, with and without evidence of cardiovascular disease, and pravastatin effects were studied within a treatment period of three to 12 weeks. Log dose-response data over the doses of 5 mg to 160 mg revealed strong linear dose-related effects on blood total cholesterol and LDL cholesterol, and a weak linear dose-related effect on blood triglycerides. There was no dose-related effect of pravastatin on blood HDL cholesterol. Pravastatin 10 mg/day to 80 mg/day reduced LDL cholesterol by 21.7% to 31.9%, total cholesterol by 16.1% to 23.3%,and triglycerides by 5.8% to 20.0%. The certainty of evidence for these effects was judged to be moderate to high. For every two-fold dose increase there was a 3.4% (95% confidence interval (CI) 2.2 to 4.6) decrease in blood LDL cholesterol. This represented a dose-response slope that was less than the other studied statins: atorvastatin, rosuvastatin, fluvastatin, pitavastatin and cerivastatin. From other systematic reviews we conducted on statins for its effect to reduce LDL cholesterol, pravastatin is similar to fluvastatin, but has a decreased effect compared to atorvastatin, rosuvastatin, pitavastatin and cerivastatin. The effect of pravastatin compared to placebo on WADES has a risk ratio (RR) of 0.81 (95% CI 0.63 to 1.03). The certainty of evidence was judged to be very low.

Authors' conclusions: Pravastatin lowers blood total cholesterol, LDL cholesterol and triglyceride in a dose-dependent linear fashion. This review did not provide a good estimate of the incidence of harms associated with pravastatin because of the lack of reporting of adverse effects in 48.4% of the randomized placebo-controlled trials.

PubMed Disclaimer

Conflict of interest statement

Stephen P Adams has no known financial, political, personal, intellectual, or religious interests that could appear to influence the work reported in this systematic review.

Nima Alaeiilkhchi has no known financial, political, personal, intellectual, or religious interests that could appear to influence the work reported in this systematic review.

Sara Tasnim has no known financial, political, personal, intellectual, or religious interests that could appear to influence the work reported in this systematic review.

James M Wright has no known financial, political, personal, intellectual, or religious interests that could appear to influence the work reported in this systematic review. He is the Co‐ordinating Editor of the Cochrane Hypertension Group. He has played no role in the editorial process for this review.

Figures

1
1
Pravastatin flow diagram
2
2
Number of included trials according to publication year
3
3
Log dose pravastatin response curve for LDL cholesterol Values represent the results of each trial for each dose comparison. The standard error bars cannot be seen because they all lie within the points
4
4
Log dose pravastatin response curve for total cholesterol Values represent the results of each trial for each dose comparison. The standard error bars cannot be seen because they all lie within the points
5
5
Log dose pravastatin response curve for triglycerides Values represent the results of each trial for each dose comparison. The standard error bars cannot be seen because they all lie within the points
6
6
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
7
7
40 mg pravastatin/day
1.1
1.1. Analysis
Comparison 1: 5 mg vs placebo, Outcome 1: LDL cholesterol
1.2
1.2. Analysis
Comparison 1: 5 mg vs placebo, Outcome 2: Total cholesterol
1.3
1.3. Analysis
Comparison 1: 5 mg vs placebo, Outcome 3: HDL cholesterol
1.4
1.4. Analysis
Comparison 1: 5 mg vs placebo, Outcome 4: Triglycerides
1.5
1.5. Analysis
Comparison 1: 5 mg vs placebo, Outcome 5: WDAE
2.1
2.1. Analysis
Comparison 2: 10 mg vs placebo, Outcome 1: LDL cholesterol
2.2
2.2. Analysis
Comparison 2: 10 mg vs placebo, Outcome 2: Total cholesterol
2.3
2.3. Analysis
Comparison 2: 10 mg vs placebo, Outcome 3: HDL cholesterol
2.4
2.4. Analysis
Comparison 2: 10 mg vs placebo, Outcome 4: Triglycerides
2.5
2.5. Analysis
Comparison 2: 10 mg vs placebo, Outcome 5: WDAE
3.1
3.1. Analysis
Comparison 3: 20 mg vs placebo, Outcome 1: LDL‐cholesterol
3.2
3.2. Analysis
Comparison 3: 20 mg vs placebo, Outcome 2: Total cholesterol
3.3
3.3. Analysis
Comparison 3: 20 mg vs placebo, Outcome 3: HDL cholesterol
3.4
3.4. Analysis
Comparison 3: 20 mg vs placebo, Outcome 4: Triglycerides
3.5
3.5. Analysis
Comparison 3: 20 mg vs placebo, Outcome 5: WDAE
4.1
4.1. Analysis
Comparison 4: 40 mg vs placebo, Outcome 1: LDL cholesterol
4.2
4.2. Analysis
Comparison 4: 40 mg vs placebo, Outcome 2: Total cholesterol
4.3
4.3. Analysis
Comparison 4: 40 mg vs placebo, Outcome 3: HDL cholesterol
4.4
4.4. Analysis
Comparison 4: 40 mg vs placebo, Outcome 4: Triglycerides
4.5
4.5. Analysis
Comparison 4: 40 mg vs placebo, Outcome 5: WDAE
5.1
5.1. Analysis
Comparison 5: 80 mg vs placebo, Outcome 1: LDL cholesterol
5.2
5.2. Analysis
Comparison 5: 80 mg vs placebo, Outcome 2: Total cholesterol
5.3
5.3. Analysis
Comparison 5: 80 mg vs placebo, Outcome 3: HDL cholesterol
5.4
5.4. Analysis
Comparison 5: 80 mg vs placebo, Outcome 4: Triglycerides
5.5
5.5. Analysis
Comparison 5: 80 mg vs placebo, Outcome 5: WDAE
6.1
6.1. Analysis
Comparison 6: 160 mg vs placebo, Outcome 1: LDL cholesterol
6.2
6.2. Analysis
Comparison 6: 160 mg vs placebo, Outcome 2: Total cholesterol
6.3
6.3. Analysis
Comparison 6: 160 mg vs placebo, Outcome 3: HDL cholesterol
6.4
6.4. Analysis
Comparison 6: 160 mg vs placebo, Outcome 4: Triglycerides
7.1
7.1. Analysis
Comparison 7: All doses of pravastatin vs placebo for withdrawals due to adverse effects, Outcome 1: WDAE
8.1
8.1. Analysis
Comparison 8: 40 mg vs placebo male versus female subgroup analysis for LDL cholesterol, Outcome 1: LDL cholesterol
9.1
9.1. Analysis
Comparison 9: 20 mg vs placebo with respect to single versus twice daily dosing subgroup analysis, Outcome 1: LDL cholesterol
10.1
10.1. Analysis
Comparison 10: 40 mg vs placebo with respect to single versus twice daily dosing subgroup analysis, Outcome 1: LDL cholesterol
11.1
11.1. Analysis
Comparison 11: 10 mg vs placebo with respect to familial versus non‐familial hypercholesterolaemia subgroup analysis, Outcome 1: LDL cholesterol
12.1
12.1. Analysis
Comparison 12: 20 mg vs placebo with respect to familial versus non‐familial hypercholesterolaemia subgroup analysis, Outcome 1: LDL cholesterol
13.1
13.1. Analysis
Comparison 13: 40 mg vs placebo with respect to familial versus non‐familial hypercholesterolaemia subgroup analysis, Outcome 1: LDL cholesterol
14.1
14.1. Analysis
Comparison 14: 20 mg vs placebo with respect to Bristol‐Myers Squibb versus Non‐Bristol‐Myers Squibb subgroup analysis, Outcome 1: LDL cholesterol
15.1
15.1. Analysis
Comparison 15: 40 mg vs placebo with respect to Bristol‐Myers Squibb versus Non‐Bristol‐Myers Squibb subgroup analysis, Outcome 1: LDL cholesterol
16.1
16.1. Analysis
Comparison 16: all doses of pravastatin vs placebo for HDL cholesterol, Outcome 1: HDL cholesterol
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD013673

References

References to studies included in this review

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Kayikcioglu 2003 {published data only}
    1. Kayikcioglu M, Payzin S, Yavuzgil O, Kultursay H, Can LH, Soydan I. Benefits of statin treatment in cardiac syndrome-X1. European Heart Journal 2003;24(22):1999-2005. [DOI: 10.1016/s0195-668x(03)00478-0] [PMID: ] - DOI - PubMed
Kim 2013 {published data only}
    1. Kim JH, Lee MR, Shin JA, Lee SS, Lee JM, You SJ, et al. Effects of pravastatin on serum adiponectin levels in female patients with type 2 diabetes mellitus. Atherosclerosis 2013;227(2):355-9. [DOI: 10.1016/j.atherosclerosis.2013.01.045] [PMID: ] - DOI - PubMed
Knipscheer 1996 {published data only}
    1. Knipscheer HC, Boelen CC, Kastelein JJ, Diermen DE, Groenemeijer BE, den Ende A, et al. Short-term efficacy and safety of pravastatin in 72 children with familial hypercholesterolemia. Pediatric Research 1996;39(5):867-71. [DOI: 10.1203/00006450-199605000-00021] - DOI - PubMed
Koh 2009 {published data only}
    1. Koh KK, Quon MJ, Han SH, Lee Y, Kim SJ, Park JB, et al. Differential metabolic effects of pravastatin and simvastatin in hypercholesterolemic patients. Atherosclerosis 2009;204(2):483-90. [DOI: 10.1016/j.atherosclerosis.2008.09.021] [PMID: ] - DOI - PMC - PubMed
Koh 2013 {published data only}
    1. Koh KK, Quon MJ, Sakuma I, Han SH, Choi H, Lee K, et al. Differential metabolic effects of rosuvastatin and pravastatin in hypercholesterolemic patients. International Journal of Cardiology 2013;166(2):509-15. [DOI: 10.1016/j.ijcard.2011.11.028] [PMID: ] - DOI - PubMed
Krempf 1997 {published data only}
    1. Krempf M, Berthezene F, Wemeau JL, Moinade S, Desriac I, Amelineau E, et al. Efficacy of low-dose pravastatin in patients with mild hyperlipidemia associated with type II diabetes mellitus. Diabetes & Metabolism 1997;23(2):131-6. [PMID: ] - PubMed
LeQuanSang 1995 {published data only}
    1. Le Quan Sang KH, Levenson J, Megnien JL, Simon A, Devynck MA. Platelet cytosolic Ca2+ and membrane dynamics in patients with primary hypercholesterolemia. Effects of pravastatin. Arteriosclerosis, Thrombosis, and Vascular Biology 1995;15(6):759-64. [DOI: 10.1161/01.atv.15.6.759] [PMID: ] - DOI - PubMed
Lewis 2007 {published data only}
    1. Lewis JH, Mortensen ME, Zweig S, Fusco MJ, Medoff JR, Belder R, Pravastatin in Chronic Liver Disease Study Investigators. Efficacy and safety of high-dose pravastatin in hypercholesterolemic patients with well-compensated chronic liver disease: results of a prospective, randomized, double-blind, placebo-controlled, multicenter trial. Hepatology 2007;46(5):1453-63. [DOI: 10.1002/hep.21848] [PMID: ] - DOI - PubMed
    1. NCT00529178. Pravastatin efficacy and safety trial in hypercholesterolemic patients with chronic liver disease. clinicaltrials.gov/show/NCT00529178 (first received 14 September 2007). [TRIAL REGISTRATION NUMBER: NCT00529178]
Ling 2005 {published data only}
    1. Ling MC, Ruddy TD, deKemp RA, Ukkonen H, Duchesne L, Higginson L, et al. Early effects of statin therapy on endothelial function and microvascular reactivity in patients with coronary artery disease. American Heart Journal 2005;149(6):1137. [DOI: 10.1016/j.ahj.2005.02.033] [PMID: ] - DOI - PubMed
Megnien 1996 {published data only}
    1. Megnien JL, Simon A, Andriani A, Segond P, Jeannin S, Levenson J. Cholesterol lowering therapy inhibits the low-flow mediated vasoconstriction of the brachial artery in hypercholesterolaemic subjects. British Journal of Clinical Pharmacology 1996;42(2):187-93. [DOI: 10.1046/j.1365-2125.1996.04047.x] [PMID: ] - DOI - PMC - PubMed
Melani 2003 {published data only}
    1. Gagne C, Bays HE, Weiss SR, Mata P, Quinto K, Melino M, et al, Ezetimibe Study Group. Efficacy and safety of ezetimibe added to ongoing statin therapy for treatment of patients with primary hypercholesterolemia. American Journal of Cardiology 2002;90(10):1084-91. [DOI: 10.1016/s0002-9149(02)02774-1] [PMID: ] - DOI - PubMed
    1. Lipka L, Sager P, Strony J, Yang B, Suresh R, Veltri E, Ezetimibe Study Group. Efficacy and safety of coadministration of ezetimibe and statins in elderly patients with primary hypercholesterolaemia. Drugs & Aging 2004;21(15):1025-32. [DOI: 10.2165/00002512-200421150-00005] [PMID: ] - DOI - PubMed
    1. Melani L, Mills R, Hassman D, Lipetz R, Lipka L, LeBeaut A, et al, Ezetimibe Study Group. Efficacy and safety of ezetimibe coadministered with pravastatin in patients with primary hypercholesterolemia: a prospective, randomized, double-blind trial. European Heart Journal 2003;24(8):717-28. [DOI: 10.1016/s0195-668x(02)00803-5] [PMID: ] - DOI - PubMed
Mercuri 1996 {published data only}
    1. Baldassarre D, Siroti CR, Veglia F, Gobbi C, Gallus, for the CAIUS Research Group. Pravastatin reduces carotid intima-media thickness progression also in patients showing an unsatisfactory response in terms of LDL-C reduction. The CAIUS study. Atherosclerosis 1997;134(1-2):296. [CENTRAL: CN-00242161]
    1. Baldassarre D, Veglia F, Gobbi C, Gallus G, Ventura A, Crepaldi G, et al. Intima-media thickness after pravastatin stabilizes also in patients with moderate to no reduction in LDL-cholesterol levels: the carotid atherosclerosis Italian ultrasound study. Atherosclerosis 2000;151(2):575-83. [DOI: 10.1016/s0021-9150(99)00434-7] [PMID: ] - DOI - PubMed
    1. Mercuri M, Bond MG, Sirtori CR, Veglia F, Crepaldi G, Feruglio FS, et al. Pravastatin reduces carotid intima-media thickness progression in an asymptomatic hypercholesterolemic mediterranean population: the Carotid Atherosclerosis Italian Ultrasound Study. American Journal of Medicine 1996;101(6):627-34. [DOI: 10.1016/s0002-9343(96)00333-6] [PMID: ] - DOI - PubMed
    1. Sirtori CR, Bianchi G, Bond MG, D'Alo G, Gallus G, Liberatore S, et al. Pravastatin intervention trial on carotid artery atherosclerosis in patients with mild hypercholesterolemia: the CAIUS study. International Journal of Cardiac Imaging 1995;11(Suppl 2):119-24. [CENTRAL: CN-00243567]
Meyers 1995 {published data only}
    1. Meyers DG, Bays HE, Weiner BH, Stoltz R. Short-term efficacy and safety of pravastatin in hypercholesterolemic women. Journal of Women's Health 1995;4(4):357-65. [DOI: 10.1089/jwh.1995.4.357] [EMBASE: 1995282454] - DOI
Morris 1996 {published data only}
    1. Morris R, Robinson G, Tilyard M, Gurr E. Pravastatin and risk factor modification in patients with moderate primary hypercholesterolaemia. New Zealand Medical Journal 1996;109(1028):319-22. [PMID: ] - PubMed
O'Callaghan 1994 {published data only}
    1. O'Callaghan CJ, Krum H, Conway EL, Lam W, Skiba MA, Howes LG, et al. Efficacy of pravastatin in combination with captopril in hypertensive patients. Medical Journal of Australia 1995;162(4):206-8. [DOI: 10.5694/j.1326-5377.1995.tb126026.x] [PMID: ] - DOI - PubMed
    1. O'Callaghan CJ, Krum H, Conway EL, Lam W, Skiba MA, Howes LG, et al. Short term effects of pravastatin on blood pressure in hypercholesterolaemic hypertensive patients. Blood Pressure 1994;3(6):404-6. [DOI: 10.3109/08037059409102294] [PMID: ] - DOI - PubMed
Pravastatin Multicenter Study Group II 1993 {published data only}
    1. Anonymous. Comparative efficacy and safety of pravastatin and cholestyramine alone and combined in patients with hypercholesterolemia. Pravastatin Multicenter Study Group II. Archives of Internal Medicine 1993;153(11):1321-9. [PMID: ] - PubMed
Ritter 1993 {published data only}
    1. Ritter JM, Sever P, Brassfield T. Pravastatin once daily in hypercholesterolaemia: A U.K. study. Journal of Clinical Pharmacy and Therapeutics 1993;18(6):421-6. [EMBASE: 1994030254]
Rosenson 2003 {published data only}
    1. Rosenson RS, Bays HE. Results of two clinical trials on the safety and efficacy of pravastatin 80 and 160 mg per day. American Journal of Cardiology 2003;91(7):878-81. [DOI: 10.1016/S0002-9149%2803%2900026-2] [PMID: ] - DOI - PubMed
Rosenson 2004 {published data only}
    1. Rosenson RS, Wolff D, Tangney CC. Statins reduce oxidized low-density lipoprotein levels, but do not alter soluble intercellular cell-adhesion molecule-1 and vascular cell-adhesion molecule-1 levels in subjects with hypercholesterolaemia. Clinical Science 2004;106(2):215-7. [DOI: 10.1042/CS20030291] [PMID: ] - DOI - PubMed
Rubenfire 1991 {published data only}
    1. Rubenfire M, Maciejko JJ, Blevins RD, Orringer C, Kobylak L, Rosman H. The effect of pravastatin on plasma lipoprotein and apolipoprotein levels in primary hypercholesterolemia. The Southeastern Michigan Collaborative Group. Archives of Internal Medicine 1991;151(11):2234-40. [PMID: ] - PubMed
Rustemeijer 1997 {published data only}
    1. Rustemeijer C, Schouten JA, Janssens EN, Spooren PF, Doormaal JJ. Pravastatin in diabetes-associated hypercholesterolemia. Acta Diabetologica 1997;34(4):294-300. [DOI: 10.1007/s005920050091] [PMID: ] - DOI - PubMed
Santinga 1994 {published data only}
    1. Santinga JT, Rosman HS, Rubenfire M, Maciejko JJ, Kobylak L, McGovern ME, et al. Efficacy and safety of pravastatin in the long-term treatment of elderly patients with hypercholesterolemia. American Journal of Medicine 1994;96(6):509-15. [DOI: 10.1016/0002-9343(94)90090-6] [PMID: ] - DOI - PubMed
Saxenhofer 1990 {published data only}
    1. Saxenhofer H, Weidmann P, Riesen WF, Beretta-Piccoli C, Fragiacomo C, Wunderlin R, et al. Therapeutic efficacy of the HMG-CoA-reductase inhibitor pravastatin in hyperlipoproteinaemia type II. European Journal of Clinical Pharmacology 1990;39(2):101-5. [DOI: 10.1007/bf00280040] [PMID: ] - DOI - PubMed
Smit 1995 {published data only}
    1. Smit JW, Erpecum KJ, Renooij W, Stolk MF, Edgar P, Doornewaard H, et al. The effects of the 3-hydroxy, 3-methylglutaryl coenzyme A reductase inhibitor pravastatin on bile composition and nucleation of cholesterol crystals in cholesterol gallstone disease. Hepatology 1995;21(6):1523-9. [DOI: 10.1016/0270-9139%2895%2990454-9] [PMID: ] - DOI - PubMed
Spitalewitz 1993 {published data only}
    1. Spitalewitz S, Porush JG, Cattran D, Wright N. Treatment of hyperlipidemia in the nephrotic syndrome: the effects of pravastatin therapy. American Journal of Kidney Diseases 1993;22(1):143-50. [DOI: 10.1016/s0272-6386(12)70180-4] [PMID: ] - DOI - PubMed
Vanhanen 1995 {published data only}
    1. Vanhanen HT, Miettinen TA. Cholesterol absorption and synthesis during pravastatin, gemfibrozil and their combination. Atherosclerosis 1995;115(2):135-46. [DOI: 10.1016/0021-9150(94)05474-w] [PMID: ] - DOI - PubMed
Vincenzi 2014 {published data only}
    1. NCT01082588. Phase 4 study of the effects of pravastatin on cholesterol levels, inflammation and cognition in schizophrenia. clinicaltrials.gov/show/NCT01082588 (first received 8 March 2010). [TRIAL REGISTRATION NUMBER: NCT01082588]
    1. Vincenzi B, Stock S, Borba CP, Cleary SM, Oppenheim CE, Petruzzi LJ, et al. A randomized placebo-controlled pilot study of pravastatin as an adjunctive therapy in schizophrenia patients: effect on inflammation, psychopathology, cognition and lipid metabolism. Schizophrenia Research 2014;159(2-3):395-403. [DOI: 10.1016/j.schres.2014.08.021] [PMID: ] - DOI - PMC - PubMed
Wiklund 1990 {published data only}
    1. Berglund L, Wiklund O, Eggertsen G, Olofsson SO, Eriksson M, Linden T, et al. Apolipoprotein E phenotypes in familial hypercholesterolaemia: importance for expression of disease and response to therapy. Journal of Internal Medicine 1993;233(2):173-8. [DOI: 10.1111/j.1365-2796.1993.tb00670.x] [PMID: ] - DOI - PubMed
    1. Wiklund O, Angelin B, Fager G, Eriksson M, Olofsson SO, Berglund L, et al. Treatment of familial hypercholesterolaemia: a controlled trial of the effects of pravastatin or cholestyramine therapy on lipoprotein and apolipoprotein levels. Journal of Internal Medicine 1990;228(3):241-7. [DOI: 10.1111/j.1365-2796.1990.tb00225.x] [PMID: ] - DOI - PubMed
    1. Wiklund O, Angelin B, Olofsson SO, Eriksson M, Fager G, Berglund L, et al. Apolipoprotein(a) and ischaemic heart disease in familial hypercholesterolaemia. Lancet 1990;335(8702):1360-3. [DOI: 10.1016/0140-6736(90)91242-3] [PMID: ] - DOI - PubMed
Wiklund 1996 {published data only}
    1. Wiklund O, Angelin B, Bergman M, Berglund L, Bondjers G, Carlsson A, et al. Pravastatin and gemfibrozil alone and in combination for the treatment of hypercholesterolemia. American Journal of Medicine 1993;94(1):13-20. [DOI: 10.1016/0002-9343(93)90114-5] [PMID: ] - DOI - PubMed
    1. Wiklund O, Bondjers G, Wright I, Camejo G. Insoluble complex formation between LDL and arterial proteoglycans in relation to serum lipid levels and effects of lipid lowering drugs. Atherosclerosis 1996;119(1):57-67. [DOI: 10.1016/0021-9150(95)05628-9] [PMID: ] - DOI - PubMed
Yasushi 1987 {published data only}
    1. Saito Y, Goto Y, Nakaya N, Hata Y, Homma Y, Naito C, et al. Dose-dependent hypolipidemic effect of an inhibitor of HMG-CoA reductase, pravastatin (CS-514), in hypercholesterolemic subjects. A double blind test. Atherosclerosis 1988;72(2-3):205-11. [DOI: 10.1016/0021-9150(88)90082-2] [PMID: ] - DOI - PubMed
    1. Yasushi S, Sho Y, Koji S, Norihiro S, Masaki S, Syunichi M, et al. Clinical study of CS-514 on hyperlipidemia: dose finding study using double-blind, three-groups comparative study. Rinsho Iyaku (Journal of Clinical Therapeutics and Medicines) 1987;3(12):1445-72. [CENTRAL: CN-00476320]
Zambon 1994 {published data only}
    1. Zambon S, Cortella A, Sartore G, Baldo-Enzi G, Manzato E, Crepaldi G. Pravastatin treatment in combined hyperlipidaemia. Effect on plasma lipoprotein levels and size. European Journal of Clinical Pharmacology 1994;46(3):221-4. [DOI: 10.1007/bf00192552] [PMID: ] - DOI - PubMed

References to studies excluded from this review

Aberg 2017 {published data only}
    1. Aberg JA, Sponseller CA, Ward DJ, Kryzhanovski VA, Campbell SE, Thompson MA. Pitavastatin versus pravastatin in adults with HIV-1 infection and dyslipidaemia (INTREPID): 12 week and 52 week results of a phase 4, multicentre, randomised, double-blind, superiority trial. Lancet 2017;4(7):e284-94. [DOI: 10.1016/S2352-3018(17)30075-9] - DOI - PubMed
Aguilar Salinas 1997 {published data only}
    1. Aguilar-Salinas CA, Hugh P, Barrett R, Pulai J, Zhu XL, Schonfeld G. A familial combined hyperlipidemic kindred with impaired apolipoprotein B catabolism. Kinetics of apolipoprotein B during placebo and pravastatin therapy. Arteriosclerosis, Thrombosis, and Vascular Biology 1997;17(1):72-82. [DOI: 10.1161/01.atv.17.1.72] - DOI - PubMed
Baker 2012 {published data only}
    1. Baker JV, Huppler Hullsiek K, Prosser R, Duprez D, Grimm R, Tracy RP, et al. Angiotensin converting enzyme inhibitor and HMG-CoA reductase inhibitor as adjunct treatment for persons with HIV infection: a feasibility randomized trial. PLOS One 2012;7(10):e46894. [DOI: 10.1371/journal.pone.0046894] - DOI - PMC - PubMed
Beigel 1993 {published data only}
    1. Beigel Y, Brook G, Eisenberg S, Fainaru M, Harats D, Levy Y, et al. Efficacy and safety of pravastatin once daily in primary moderate hypercholesterolemia: the Israeli experience. Israel Journal of Medical Sciences 1993;29(5):272-7. [PMID: ] - PubMed
Bennett 2004 {published data only}
    1. Bennett S, Sager P, Lipka L, Melani L, Suresh R, Veltri E, Ezetimibe Study Group. Consistency in efficacy and safety of ezetimibe coadministered with statins for treatment of hypercholesterolemia in women and men. Journal of Women's Health 2004;13(10):1101-7. [DOI: 10.1089/jwh.2004.13.1101] [PMID: ] - DOI - PubMed
Bonnet 2007 {published data only}
    1. Bonnet F, Aurillac-Lavignolle V, Breilh D, Thiebaut R, Peuchant E, Bernard N, et al. Pravastatin in HIV-infected patients treated with protease inhibitors: a placebo-controlled randomized study. HIV Clinical Trials 2007;8(1):53-60. [DOI: 10.1310/hct0801-53] - DOI - PubMed
Castelao 1995 {published data only}
    1. Castelao AM, Grinyo JM, Castineiras MJ, Fiol C, Gilvernet S, Seron D, et al. Effect of pravastatin in the treatment of hypercholesterolemia after renal transplantation under cyclosporine and prednisone. Transplantation Proceedings 1995;27(4):2217-20. [PMID: ] - PubMed
Cobbaert 1992 {published data only}
    1. Cobbaert C, Sergeant P, Meyns B, Szecsi J, Kesteloot H. Time course of serum Lp(a) in men after coronary artery bypass grafting. Acta Cardiologica 1992;47(6):529-42. [PMID: ] - PubMed
Cueto Manzano 2013 {published data only}
    1. Cueto-Manzano AM, Angel-Zuniga JR, Ornelas-Carrillo G, Rojas-Campos E, Martinez-Ramirez HR, Cortes-Sanabria L. Anti-inflammatory interventions in end-stage kidney disease: a randomized, double-blinded, controlled and crossover clinical trial on the use of pravastatin in continuous ambulatory peritoneal dialysis. Archives of Medical Research 2013;44(8):633-7. [DOI: 10.1016/j.arcmed.2013.10.016] - DOI - PubMed
Cutler 1995 {published data only}
    1. Cutler N, Sramek J, Veroff A, Block G, Stauffer L, Lines C. Effects of treatment with simvastatin and pravastatin on cognitive function in patients with hypercholesterolaemia. British Journal of Clinical Pharmacology 1995;39(3):333-6. [DOI: 10.1111/j.1365-2125.1995.tb04458.x] [PMID: ] - DOI - PMC - PubMed
Dangas 1999a {published data only}
    1. Dangas G, Smith DA, Badimon JJ, Unger AH, Shao JH, Meraj P, et al. Gender differences in blood thrombogenicity in hyperlipidemic patients and response to pravastatin. American Journal of Cardiology 1999;84(6):639-43. [DOI: 10.1016/s0002-9149(99)00408-7] [PMID: ] - DOI - PubMed
Dangas 1999b {published data only}
    1. Dangas G, Badimon JJ, Smith DA, Unger AH, Levine D, Shao JH, et al. Pravastatin therapy in hyperlipidemia: effects on thrombus formation and the systemic hemostatic profile. Journal of the American College of Cardiology 1999;33(5):1294-304. [DOI: 10.1016/s0735-1097(99)00018-2] - DOI - PubMed
Dangas 2000 {published data only}
    1. Dangas G, Smith DA, Unger AH, Shao JH, Meraj P, Fier C, et al. Pravastatin: an antithrombotic effect independent of the cholesterol-lowering effect. Thrombosis and Haemostasis 2000;83(5):688-92. [PMID: ] - PubMed
Dobs 1995 {published data only}
    1. Dobs AS, Prasad M, Goldberg A, Guccione M, Hoover DR. Changes in serum lipoprotein(a) in hyperlipidemic subjects undergoing long-term treatment with lipid-lowering drugs. Cardiovascular Drugs and Therapy 1995;9(5):677-84. [DOI: 10.1007/bf00878550] - DOI - PubMed
Eckernas 1993 {published data only}
    1. Eckernas SA, Roos BE, Kvidal P, Eriksson LO, Block GA, Neafus RP, et al. The effects of simvastatin and pravastatin on objective and subjective measures of nocturnal sleep: a comparison of two structurally different HMG CoA reductase inhibitors in patients with primary moderate hypercholesterolaemia. British Journal of Clinical Pharmacology 1993;35(3):284-9. [PMID: ] - PMC - PubMed
Ehrenberg 1999 {published data only}
    1. Ehrenberg BL, Lamon-Fava S, Corbett KE, McNamara JR, Dallal GE, Schaefer EJ. Comparison of the effects of pravastatin and lovastatin on sleep disturbance in hypercholesterolemic subjects. Sleep 1999;22(1):117-21. [DOI: 10.1093/sleep/22.1.117] - DOI - PubMed
EUCTR2004 003235 31 AT {published data only}
    1. EUCTR2004-003235-31-AT. Effect of pravastatin or fluvastatin and add-on valsartan on inflammatory markers and peripheral endothelial function in patients with acute coronary syndrome [Effect of pravastatin or fluvastatin and add-on valsartan on inflammatory markers and peripheral endothelial function in patients with acute coronary syndrome]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2004-003235-31-AT (first received 3 January 2005). [TRIAL REGISTRATION NUMBER: EUCTR2004-003235-31-AT]
EUCTR2006 000515 15 GR 2006 {published data only}
    1. EUCTR2006-000515-15-GR. A multicenter, double-blind, randomized, forced-titration study to compare the efficacy and safety of the combination of 145 mg fenofibrate and 20 or 40 mg simvastatin with 40 mg pravastatin monotherapy in patients with mixed dyslipidemia at risk of cardiovascular disease not adequately controlled by 40 mg pravastatin alone [A multicenter, double-blind, randomized, forced-titration study to compare the efficacy and safety of the combination of 145 mg fenofibrate and 20 or 40 mg simvastatin with 40 mg pravastatin monotherapy in patients with mixed dyslipidemia at risk of cardiovascular disease not adequately controlled by 40 mg pravastatin alone]. http://www.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2006-000515-15-GR (first received 31 August 2006). [TRIAL REGISTRATION NUMBER: EUCTR2006-000515-15-GR]
Ferrari 1993 {published data only}
    1. Ferrari P, Weidmann P, Riesen WF, Martius F, Luban S, Pasotti E, et al. Pravastatin in the treatment of primary hypercholesterolemia: a Swiss multicenter study [Pravastatin zur Behandlung der primaren Hypercholesterinamie: Schweizer Multizenter-Studie]. Schweizerische Medizinische Wochenschrift. Journal Suisse de Medecine 1993;123(37):1736-41. [PMID: ] - PubMed
Fogari 1992 {published data only}
    1. Fogari R, Tettamanti F, Zoppi A, Malamani GD, Lazzari P, Agosta G, et al. Effects of chronic treatment with pravastatin in patients with mild hypercholesterolemia and associated cardiovascular risk factors. Current Therapeutic Research 1992;51(6):896-905. [EMBASE: 1992190213]
Gengo 1995 {published data only}
    1. Gengo F, Cwudzinski D, Kinkel P, Block G, Stauffer L, Lines C. Effects of treatment with lovastatin and pravastatin on daytime cognitive performance. Clinical Cardiology 1995;18(4):209-14. [DOI: 10.1002/clc.4960180406] [PMID: ] - DOI - PubMed
Glorioso 1999 {published data only}
    1. Glorioso N, Troffa C, Filigheddu F, Dettori F, Soro A, Parpaglia PP, et al. Effect of the HMG-CoA reductase inhibitors on blood pressure in patients with essential hypertension and primary hypercholesterolemia. Hypertension 1999;34(6):1281-6. [DOI: 10.1161/01.hyp.34.6.1281] - DOI - PubMed
Harrison 1994 {published data only}
    1. Harrison RW, Ashton CH. Do cholesterol-lowering agents affect brain activity? A comparison of simvastatin, pravastatin, and placebo in healthy volunteers. British Journal of Clinical Pharmacology 1994;37(3):231-6. [DOI: 10.1111/j.1365-2125.1994.tb04268.x] - DOI - PMC - PubMed
Hunninghake 1990a {published data only}
    1. Hunninghake DB, Knopp RH, Schonfeld G, Goldberg AC, Brown WV, Schaefer EJ, et al. Efficacy and safety of pravastatin in patients with primary hypercholesterolemia. I. A dose-response study. Atherosclerosis 1990;85(1):81-9. [DOI: 10.1016/0021-9150(90)90185-l] [PMID: ] - DOI - PubMed
Hunninghake 1990b {published data only}
    1. Hunninghake DB, Mellies MJ, Goldberg AC, Kuo PT, Kostis JB, Schrott HG, et al. Efficacy and safety of pravastatin in patients with primary hypercholesterolemia. II. Once-daily versus twice-daily dosing. Atherosclerosis 1990;85(2-3):219-27. [DOI: 10.1016/0021-9150(90)90114-x] [PMID: ] - DOI - PubMed
Hunninghake 1993 {published data only}
    1. Hunninghake DB, Stein EA, Mellies MJ. Effects of one year of treatment with pravastatin, an HMG-CoA reductase inhibitor, on lipoprotein a. Journal of Clinical Pharmacology 1993;33(6):574-80. [DOI: 10.1002/j.1552-4604.1993.tb04706.x] [PMID: ] - DOI - PubMed
Imai 1999 {published data only}
    1. Imai Y, Suzuki H, Saito T, Tsuji I, Abe K, Saruta T. The effect of pravastatin on renal function and lipid metabolism in patients with renal dysfunction with hypertension and hyperlipidemia. Pravastatin and Renal Function Research Group. Clinical and Experimental Hypertension 1999;21(8):1345-55. [DOI: 10.3109/10641969909070853] - DOI - PubMed
Isaacsohn 2001 {published data only}
    1. Isaacsohn J, Insull W Jr, Stein E, Kwiterovich P, Patrick MA, Brazg R, et al, Cerivastatin Study Group. Long-term efficacy and safety of cerivastatin 0.8 mg in patients with primary hypercholesterolemia. Clinical Cardiology 2001;24(9 Suppl):IV1-9. [DOI: 10.1002/clc.4960240902] - DOI - PMC - PubMed
Ismail 1990 {published data only}
    1. Ismail F, Corder CN, Epstein S, Barbi G, Thomas S. Effects of pravastatin and cholestyramine on circulating levels of parathyroid hormone and vitamin D metabolites. Clinical Therapeutics 1990;12(5):427-30. [PMID: ] - PubMed
Jay 1990 {published data only}
    1. Jay RH, Rampling MW, Betteridge DJ. Abnormalities of blood rheology in familial hypercholesterolaemia: effects of treatment. Atherosclerosis 1990;85(2-3):249-56. [DOI: 10.1016/0021-9150(90)90117-2] - DOI - PubMed
    1. Jay RH, Rampling MW, Betteridge DJ. Comparison of effects of pravastatin and cholestyramine on blood rheology in familial hypercholesterolaemia. Journal of Drug Development, Supplement 1990;3(1):179-84. [EMBASE: 1990360781]
Kesteloot 1992 {published data only}
    1. Kesteloot H, Cobbaert C, Meyns B, Szecsi J, Lesaffre E, Sergeant P. Time course of serum lipid and lipoprotein levels after coronary bypass surgery: modification by pravastatin. Acta Cardiologica 1992;47(6):519-28. [PMID: ] - PubMed
Kesteloot 1997 {published data only}
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NCT00177580 2005 {published data only}
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NCT00221754 2005 {published data only}
    1. NCT00221754. Pravastatin and protease inhibitors in HIV-infected patients [Pravastatin in HIV-infected patients treated with highly active antiretroviral therapy]. https://clinicaltrials.gov/show/NCT00221754 (first received 22 September 2005). [TRIAL REGISTRATION NUMBER: NCT00221754]
NCT00227500 2005 {published data only}
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NCT00245388 2005 {published data only}
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Owens 1991 {published data only}
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