The comparison of the effects of standard 20 mg atorvastatin daily and 20 mg atorvastatin every other day on serum LDL-cholesterol and high sensitive C-reactive protein levels.
Level 2 - randomized trial
Individual randomized controlled trial
What was done
Sixty-one patients with total cholesterol above 200 mg/dL and LDL-cholesterol above 130 mg/dL were randomized to receive atorvastatin 20 mg daily or atorvastatin 20 mg every other day in a prospective trial. Serum lipid profiles and high-sensitivity C-reactive protein (hs-CRP) were measured at baseline, 1 month, and 3 months.
What was found
At 1 month, LDL-cholesterol decreased by 36.1% with alternate-day dosing (p < 0.01) and by 41% with daily dosing (p < 0.01). At 3 months, the alternate-day group had an additional 10.2% decrease from month 1 (p > 0.05), and differences in lipid changes between the two groups were not statistically significant. At 1 month, hs-CRP decreased by 21% with alternate-day dosing (p < 0.05) and by 37% with daily dosing (p < 0.05); the between-group difference was not statistically significant (p > 0.05).
Why it matters
Alternate-day atorvastatin dosing appears to provide lipid-lowering and anti-inflammatory effects comparable to daily dosing, potentially offering a lower-cost option or alternative for intolerant patients.
Limits
Small sample size (n = 61) and short follow-up duration (3 months). The abstract does not report blinding, adherence tracking, tolerability, adverse event rates, or long-term cardiovascular outcomes.
Cited by
- supports Studies by Paul Ridker and others have shown that low doses of statins taken intermittently (such as 5 mg every other day or twice a week) significantly reduce vascular inflammation.