Effects of low-dose pravastatin on plasma levels of lipids and apolipoproteins in Japanese type II hyperlipoproteinemic subjects with apolipoprotein E phenotype E3/2, E3/3, and E4/3.

Effects of 12 weeks of treatment with pravastatin at a dose of 20 mg/day were compared in subjects with type II hyperlipoproteinemia with apo+(lipoprotein) E phenotype E3/2, E3/3, and E4/3. There were no differences in age, body mass index, smoking status, complications, or plasma levels of lipids and apoproteins, except the higher levels of apo E in E3/2 subjects (n = 11) than in E3/3 subjects (n = 84) and E4/3 subjects (n = 28). Plasma levels of low-density lipoprotein cholesterol (LDL-C) were reduced by 47% +/- 8% (mean +/- SD) in E3/2 subjects, 36% +/- 10% in E3/3 subjects, and 26% +/- 12% in E4/3 subjects after 12 weeks of treatment with pravastatin (all p < 0.0001). Plasma levels of apo B were decreased by 40% +/- 12% in E3/2 subjects, 27% +/- 10% in E3/3 subjects, and 18% +/- 14% in E4/3 subjects after 12 weeks of treatment with pravastatin (all p < 0.0001). The reduction in plasma levels of LDL-C and apo B was most marked in E3/2 subjects, next in E3/3 subjects, and smallest in E4/3 subjects. The authors conclude that treatment with pravastatin at a dose of 20 mg/day in Japanese subjects is equally effective as 40 mg/day in Western subjects, and apo Epolymorphism is a factor to determine the efficacy of pravastatin in Japanese subjects.