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Saito S – Pitavastatin is a potent HMG–CoA reductase inhibitor and efficient hepatocyte low–density lipoprotein cholesterol (LDL–C) receptor inducer, producing robust reduction of the serum LDL–C levels, even at a low dose. Pitavastatin and its lactone form are minimally metabolized by CYP enzymes, and are therefore associated with minimal drug–drug interactions (DDIs). Pitavastatin 2 to 4 mg has potent LDL–C–reducing activity, equivalent to that of atorvastatin 10 to 20 mg; several clinical trials have revealed consistently superior high–density lipoprotein cholesterol (HDL–C) elevating activity of pitavastatin than that of atorvastatin. Pitavastatin–induced HDL–C elevation has been shown to be sustained, even incremental, in long–term clinical trials. Pitavastatin was as well–tolerated as atorvastatin or simvastatin in double–blind randomized clinical trials. Two–year long–term safety and effectiveness of pitavastain has been confirmed in a large–scale, prospective post–marketing surveillance. In addition to control of LDL–C, adequate control of triglyceride (TG) and HDL–C, hypertension and hyperglycemia is also necessary in metabolic syndrome patients.

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