Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
To the Editor: Dr Downs and
colleagues1 state that there were no differences between
lovastatin at 20 mg/d and placebo for "clinically important"
elevations in transaminases (>3 times the normal upper limit) and
creatine kinase (>10 times the normal upper limit). More complete
data should be given to allow readers to make their own judgment on the
clinical importance of these (possibly other) adverse effects. Second,
the dose of lovastatin was titrated to optimize lipid reduction. Half
the subjects needed maintenance at 40 mg/d, but they were excluded from
analysis of the above adverse effects. Third, 42% of treated subjects
reached the study target for low-density lipoprotein cholesterol
(LDL-C), but they were not compared with those who did not. This seems
a strange oversight in a study designed to determine the benefit of
Krut LH. Coronary Events With Lipid-Lowering Therapy: The AFCAPS/TexCAPS Trial. JAMA. 1999;281(5):414–419. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-5-jbk0203
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