A comparative study of policosanol versus pravastatin in patients with type II hypercholesterolemia

This randomized, double-masked study compared the short-term efficacy and tolerability of policosanol and pravastatin in patients with type II hypercholesterolemia. After following a step I cholesterol-lo wering diet for 6 weeks, 24 patients with type II hypercholesterolemia were randomly assigned to receive policosanol or pravastatin administered at the same dose (10 mg/d) for 6 weeks. Both groups mere statistically similar at randomization. Policosanol significantly reduced total cholesterol (15.7%), low-density lipoprotein (LDL) cholesterol (24.2%), and triglycerides (8.7%), as web as the atherogenic ratios of total cholesterol to high-density lipoprotein (HDL) cholesterol (25.7%), and LDL cholesterol to HDL cholesterol (33.0%). Pravastatin significantly lowered total cholesterol by 15.3%, LDL cholesterol by 19.6%, triglycerides by 13.9%, and the atherogenic ratios of total cholesterol to HDL cholesterol (18.7%) and LDL cholesterol to HDL cholesterol (22.8%). Mean values of HDL cholesterol mere significantly increased by 13.6% after treatment with policosanol, and were increased by 4.7% after treatment with pravastatin. Comparisons between groups showed that the percentage change in LDL and HDL cholesterol levels, and in atherogenic ratios were significantly higher in the policosanol group than in the pravastatin group. Both drugs were well tolerated. A significant increase in mean aspartate aminotransferase level was observed in the pravastatin group, but individual values remained within the normal range. No patient withdrew from the study because of adverse events. Four moderate adverse events (nausea, dizziness, abdominal pain, and pruritus) were reported by pravastatin-treated patients. The other adverse events reported (five in each group) were classified as mild. These results suggest that both policosanol and pravastatin are suitable alternatives for treating type II hypercholesterolemia, but that policosanol administered at 10 mg/d shows modest advantages compared with pravastatin administered at the same dose.