From the Guidelines
Pitavastatin is not primarily an anti-inflammatory drug, but rather a statin medication used to lower cholesterol levels in the blood, with some pleiotropic effects that may be beneficial in specific patient groups. Pitavastatin works by inhibiting an enzyme called HMG-CoA reductase, which is involved in cholesterol production in the liver, and has been shown to reduce LDL-C effectively, with a mean reduction of 43-47% 1. While statins like pitavastatin may have some anti-inflammatory effects as a secondary benefit, this is not their primary mechanism of action or intended use.
Key Points
- Pitavastatin is a potent inhibitor of HMG-coenzyme A reductase, reducing LDL-C effectively 1
- It has some pleiotropic effects, which may be particularly beneficial in specific patient groups, such as those with metabolic disturbances, diabetes, or pre-diabetes 1
- Pitavastatin has been shown to reduce subsequent and total CVD events, and has a significant potential to reduce muscle-related symptoms and diabetes mellitus 1
- The recommended dose of pitavastatin is 1-4 mg once daily, and it is essential to take the medication as directed by your healthcare provider and to have regular blood tests to monitor cholesterol levels and liver function while on this medication.
Clinical Use
Pitavastatin is typically prescribed for managing high cholesterol levels, and its use has been endorsed by the Polish Expert Group on the use of pitavastatin in the treatment of lipid disorders 1. The recent REPRIVE trial has also confirmed the drug's essential role in the personalisation of therapy, particularly in patients with statin intolerance, HIV, and elevated Lp(a) levels 1. The use of pitavastatin as a rational treatment choice in patients with metabolic disturbances, diabetes, or pre-diabetes is recommended, due to its potential to reduce the risk of NOD and improve adherence 1.
From the Research
Pitavastatin's Anti-Inflammatory Effects
Pitavastatin has been shown to have anti-inflammatory effects in several studies. The key findings include:
- Pitavastatin reduced the serum monocyte chemoattractant protein (MCP)-1 values by -28% in patients treated with pitavastatin, indicating its anti-inflammatory effects 2.
- Pitavastatin has been suggested to have beneficial effects on endothelial function, stabilization of the coronary plaque, anti-inflammatory effects, and anti-oxidation in vitro 3.
- A review of pitavastatin's use in the management of hypercholesterolaemia or mixed dyslipidaemia noted its potential anti-inflammatory effects, although the primary focus was on its lipid-lowering efficacy 4.
- Pitavastatin's pharmacological profile, including its ability to inhibit cholesterol synthesis and elevate high-density lipoprotein-cholesterol, may contribute to its anti-inflammatory effects 5.
- While not specifically focused on pitavastatin, a review of the anti-inflammatory effects of statins in general discussed the clinical and experimental evidence underlying these effects, which may be relevant to pitavastatin's mechanism of action 6.
Comparison to Other Statins
Pitavastatin's anti-inflammatory effects have been compared to those of other statins, such as atorvastatin. The key findings include:
- Pitavastatin and atorvastatin had different effects on inflammation, insulin resistance, and the progression of carotid atherosclerosis in patients with dyslipidemia, with pitavastatin showing more favorable effects 2.
- Pitavastatin produced more significant changes from baseline in LDL-C, TG, and HDL-C in patients with hypercholesterolemia and metabolic syndrome compared to atorvastatin 3.