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Does fiber prevent colon cancer? I'm confused about whether I should eat a high-fiber diet to prevent colon cancer. Some studies say yes, but others say fiber encourages tumor growth. […]

Background: Statins (3-hydroxy-3-methylglutaryl-coenzyme A [HMG-CoA] reductase inhibitors) have been used for a decade to lower low-density lipoprotein (LDL) cholesterol levels and to improve cardiovascular disease and clinical outcomes. Objective: To evaluate the safety profile of atorvastatin (Lipitor). Methods: Data were pooled for 21 completed (2502 patients) and 23 ongoing (1769 patients) clinical trials of atorvastatin conducted in US and international community- and university-based research centers. In these trials, patients with lipid disorders received atorvastatin at dosages of 10 to 80 mg/d. The majority of patients had moderate to severe hypercholesterolemia and were treated from 4 weeks to more than 24 months. Main Outcome Measures: Transaminase and creatine phosphokinase levels and adverse events were recorded. Results: Atorvastatin was well tolerated; fewer than 2% of the atorvastatin-treated patients withdrew due to drug-attributable adverse events. The overall adverse event profile for atorvastatin was similar to that observed with other statins. The most common adverse events with atorvastatin as well as with other statins tested were constipation, flatulence, dyspepsia, and abdominal pain. Approximately 5% of atorvastatin-treated patients had serious adverse events; only 2 of these events were possibly associated with treatment. Thirty patients (0.7%) had confirmed transaminase elevations greater than 3 times the upper limit of the normal range. Most elevations occurred within 16 weeks of beginning treatment. No patients had a conclusive characterization of drug-induced myopathy. Conclusions: The safety profile of atorvastatin was consistent with that of all statins tested and was similar to that seen in all compounds of this class. Arch Intern Med. 1998;158:577-584

BACKGROUND: To assess the lipid-lowering effects and safety of atorvastatin and niacin in patients with combined hyperlipidemia or isolated hypertriglyceridemia. METHODS: We performed a randomized, open-label, parallel-design, active-controlled, study in eight centers in the United States. We enrolled 108 patients with total cholesterol (TC) of [is greater than or equal to] 200 mg/dL, serum triglycerides (TG) [is greater than or equal to] 200 and [is less than or equal to] 800 mg/dL, and apolipoprotein B (apo B) [is greater than or equal to] 110 mg/dL. Patients were randomly assigned to receive atorvastatin 10 mg once daily (n = 55) or immediate-release niacin 1 g three times daily for 12 weeks (n = 53). Patients were stratified based on low-density lipoprotein cholesterol (LDL-C): Patients with LDL-C [is greater than or equal to] 135 mg/dL were considered to have combined hyperlipidemia and patients with LDL-C [is less than] 135 mg/dL were considered to have isolated hypertriglyceridemia. The primary outcome measure was percent change from baseline in LDL-C. Other lipid levels were evaluated as secondary parameters. RESULTS: Atorvastatin reduced LDL-C 30% and TC 26% from baseline, and increased high-density lipoprotein cholesterol (FIDL-C) 4%. Total TG were reduced 17%. Niacin reduced LDL-C 2%, TC 7%, increased HDL-C 25%, and reduced total TG 29% from baseline. There was a significant difference in LDL-C reduction, the primary efficacy parameter, between the two treatment groups (P [is less than] 0.05, favoring atorvastatin), as well as a significant difference in the improvement in HDL-C (P [is less than] 0.05, favoring niacin). The effect of atorvastatin was relatively consistent between patients with combined hyperlipidemia and isolated hypertriglyceridemia, whereas there was more variability between these strata in the niacin treatment group. Atorvastatin was better tolerated than niacin. CONCLUSION: Atorvastatin may allow patients with combined hyperlipidemia to be treated with monotherapy and offers an efficacious and well-tolerated alternative to niacin for the treatment of patients with isolated hypertriglyceridemia. Am J Med. 1998;104:137-143. [C] 1998 by Excerpta. Medica, Inc.

Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes. The MIRACL study: a randomized controlled trial. JAMA 2001; 285:1711-18. [...]

ORLANDO, FLA. -- Daily treatment with 80 mg of atorvastatin led to a startling halt in the progression of atherosclerotic disease, measured by intravascular ultrasound, in a study with 502 [...]

Consumer Reports, a non-profit magazine published in the United States has started a new venture to rate drugs based on price and effectiveness. As per the ratings by the magazine, lovastatin and Lipitor (atorvastatin) have taken the top positions in medicine buys.

Norwegian branch of Pfizer organized a meeting of over 100 medical and regulatory persons to highlight the benefits of switching to its cholesterol lowerer Lipitor (atorvastatin) from Merck Sharp & DhomeEs Zocor (simvastatin). Pfizer took the step in view of Norwegian Medicines AgencyEs move to examine the high reimbursement costs of statins.

Information on the therapeutic efficiency of AstraZeneca's Crestor and Pfizer's Lipitor in lowering LDL-cholesterol levels is offered. Additional information on clinical trials of both drugs is included.