A Cochrane review [Abstract] 1 included 145 studies (36 placebo controlled and 109 before and after) with a total of 18 846 subjects of any age with and without cardiovascular diseases. The studies evaluated dose-related efficacy of fluvastatin during 3 to 12 weeks treatment. Log dose-response data over doses of 2.5 mg to 80 mg revealed strong linear dose-related effects on blood total cholesterol and LDL cholesterol, a weak linear dose-related effect on triglycerides, and no dose-related effect on HDL cholesterol. Fluvastatin 10 mg/day to 80 mg/day reduced LDL cholesterol by 15% to 33%, total cholesterol by 11% to 25% and triglycerides by 3% to 17.5%. For every two-fold dose increase there was a 6.0% decrease in LDL cholesterol, a 4.2% decrease in total cholesterol and a 4.2% decrease in triglycerides.
Fluvastatin was about 12-fold less potent than atorvastatin and 46-fold less potent than rosuvastatin in lowering LDL cholesterol. This means that fluvastatin 80 mg/day reduced LDL cholesterol on average by 33%; the dose of atorvastatin and rosuvastatin to achieve the same reduction in LDL cholesterol is 7 mg/day and 2 mg/day, respectively.
This review did not provide a good estimate of the incidence of harms associated with fluvastatin because of the short duration of the studies and the lack of reporting of adverse effects in 56% of the placebo-controlled studies. The pooled estimate for all doses provided a RR of 1.52 (95% CI 0.94 to 2.45; 16 studies, n=3 023).
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