Best studies on Atorvastatin:

Safety of High-Intensity Statins in the Veteran Population: Atorvastatin 40 to 80 mg Compared With Rosuvastatin 20 to 40 mg.  Stein B, Ward T, Hale G, Lyver E.  Ann Pharmacother. 2019 Nov 12:1060028019888487. doi: 10.1177/1060028019888487.

Atorvastatin Exerts Antileukemia Activity via Inhibiting Mevalonate-YAP Axis in K562 and HL60 Cells.  Zhang L, Chen T, Dou Y, Zhang S, Liu H, Khishignyam T, Li X, Zuo D, Zhang Z, Jin M, Wang R, Qiu Y, Zhong Y, Kong D.  Front Oncol. 2019 Oct 9;9:1032. doi: 10.3389/fonc.2019.01032.

Microdosing clinical study to clarify pharmacokinetic and pharmacogenetic characteristics of atorvastatin in Japanese hypercholesterolemic patients.  Lee N, Maeda K, Fukizawa S, Ieiri I, Tomaru A, Akao H, Takeda K, Iwadare M, Niwa O, Masauji T, Yamane N, Kajinami K, Kusuhara H, Sugiyama Y.  Drug Metab Pharmacokinet. 2019 Aug 29. pii: S1347-4367(19)30068-0. doi: 10.1016/j.dmpk.2019.08.004.

Phase I/IIa Trial of Atorvastatin in Patients with Acute Kawasaki Disease with Coronary Artery Aneurysm.  Tremoulet AH, Jain S, Jone PN, Best BM, Duxbury EH, Franco A, Printz B, Dominguez SR, Heizer H, Anderson MS, Glodé MP, He F, Padilla RL, Shimizu C, Bainto E, Pancheri J, Cohen HJ, Whitin JC, Burns JC.  J Pediatr. 2019 Sep 24. pii: S0022-3476(19)30972-2. doi: 10.1016/j.jpeds.2019.07.064.

Impaired Glucagon Suppression And Reduced Insulin Sensitivity In Subjects With Prediabetes Undergoing Atorvastatin Therapy.  Urbano F, Di Pino A, Scicali R, Filippello A, Di Mauro S, Scamporrino A, Marchisello S, Rabuazzo AM, Purrello F, Piro S.  Eur J Endocrinol. 2019 Sep 1. pii: EJE-19-0173.R2. doi: 10.1530/EJE-19-0173.

A novel direct method to determine adherence to atorvastatin therapy in patients with coronary heart disease.  Kristiansen O, Vethe NT, Fagerland MW, Bergan S, Munkhaugen J, Husebye E.  Br J Clin Pharmacol. 2019 Sep 8. doi: 10.1111/bcp.14122.

Treatment with Free Triple Combination Therapy of Atorvastatin, Perindopril, Amlodipine in Hypertensive Patients: A Real-World Population Study in Italy.  Perrone V, Veronesi C, Gambera M, Nati G, Perone F, Tagliabue PF, Degli Esposti L, Volpe M.  High Blood Press Cardiovasc Prev. 2019 Oct;26(5):399-404. doi: 10.1007/s40292-019-00336-2.

Impact of Macroprolactinemia on Cardiometabolic Effects of Atorvastatin in Women With Hypercholesterolemia.  Krysiak R, Kowalcze K, Okopień B.  Am J Cardiol. 2019 Oct 15;124(8):1207-1212. doi: 10.1016/j.amjcard.2019.07.017

Effects of Preoperative Atorvastatin Treatment On Erectile Function After Radical Prostatectomy: Results From a Subgroup of ESTO1, a Randomized, Double-Blind, Placebo-Controlled Study.  Siltari A, Riikonen J, Fode M, Murtola TJ.  J Sex Med. 2019 Oct;16(10):1597-1605. doi: 10.1016/j.jsxm.2019.07.001

Atorvastatin attenuates cardiac hypertrophy through AMPK/miR-143-3p/Bcl2 axis.  Sun J, Zhang C, Zhang Z.  Arch Physiol Biochem. 2019 Jul 29:1-7. doi: 10.1080/13813455.2019.1643377.

Atorvastatin Attenuates Cold-Induced Hypertension by Preventing Gut Barrier Injury.  Zhang S, Zhang Y, Ahsan MZ, Yuan Y, Liu G, Han X, Zhang J, Zhao X, Bai B, Li Y.  J Cardiovasc Pharmacol. 2019 Aug;74(2):143-151. doi: 10.1097/FJC.0000000000000690.

The Effect of Atorvastatin (and Subsequent Metformin) on Adipose Tissue Acylation-Stimulatory-Protein Concentration and Inflammatory Biomarkers in Overweight/Obese Women With Polycystic Ovary Syndrome.  Sathyapalan T, Hobkirk JP, Javed Z, Carroll S, Coady AM, Pemberton P, Smith A, Cianflone K, Atkin SL.  Front Endocrinol (Lausanne). 2019 Jun 25;10:394. doi: 10.3389/fendo.2019.00394

Comparison of efficacy and safety of atorvastatin 5% lotion and betamethasone 0.1% lotion in the treatment of scalp seborrheic dermatitis.  Sobhan M, Gholampoor G, Firozian F, Mohammadi Y, Mehrpooya M.  Clin Cosmet Investig Dermatol. 2019 Apr 29;12:267-275. doi: 10.2147/CCID.S196412.

Treatment of Relapsed Chronic Subdural Hematoma in Four Young Children with Atorvastatin and Low-dose Dexamethasone.  Huang J, Li L, Zhang J, Gao C, Quan W, Tian Y, Sun J, Tian Q, Wang D, Dong J, Zhang J, Jiang R.  Pharmacotherapy. 2019 Jul;39(7):783-789. doi: 10.1002/phar.2276.

Efficacy and Safety of Ezetimibe in Combination with Atorvastatin for Acute Coronary Syndrome Patients Accompanied with Type 2 Diabetes: A Single-Center, Non-randomized Cohort Study.  Huang Z, Li Q, Ye W, Zhang Q, Li X.  Chem Pharm Bull (Tokyo). 2019;67(5):419-425. doi: 10.1248/cpb.c18-00685.

Atorvastatin Has a Dose-Dependent Beneficial Effect on Kidney Function and Associated Cardiovascular Outcomes: Post Hoc Analysis of 6 Double-Blind Randomized Controlled Trials.  Vogt L, Bangalore S, Fayyad R, Melamed S, Hovingh GK, DeMicco DA, Waters DD.  J Am Heart Assoc. 2019 May 7;8(9):e010827. doi: 10.1161/JAHA.118.010827.

A Multicenter, Randomized, Placebo-Controlled Trial of Atorvastatin for the Primary Prevention of Cardiovascular Events in Patients With Rheumatoid Arthritis.  Kitas GD, Nightingale P, Armitage J, Sattar N, Belch JJF, Symmons DPM; TRACE RA Consortium.  Arthritis Rheumatol. 2019 Sep;71(9):1437-1449. doi: 10.1002/art.40892.

Comparison of Rosuvastatin Versus Atorvastatin for Coronary Plaque Stabilization.  Thondapu V, Kurihara O, Yonetsu T, Russo M, Kim HO, Lee H, Soeda T, Minami Y, Jang IK.  Am J Cardiol. 2019 May 15;123(10):1565-1571. doi: 10.1016/j.amjcard.2019.02.019.

Atorvastatin Prevents Myocardial Fibrosis in Spontaneous Hypertension via Interleukin-6 (IL-6)/Signal Transducer and Activator of Transcription 3 (STAT3)/Endothelin-1 (ET-1) Pathway.  Fang T, Guo B, Xue L, Wang L.  Med Sci Monit. 2019 Jan 11;25:318-323. doi: 10.12659/MSM.912032.

Safety

Acute Colchicine-induced Neuromyopathy in a Patient Treated with Atorvastatin and Clarithromycin.  Olmos-Martínez JM, Molina H, Salas C, Olmos JM, Hernández JL.  Eur J Case Rep Intern Med. 2019 Mar 18;6(3):001066. doi: 10.12890/2019_001066

Acute renal failure secondary to rhabdomyolysis in a patient receiving treatment with ticagrelor and atorvastatin.  Martín Navarro JA, Gutiérrez Sánchez MJ, Petkov Stoyanov V, Jiménez Herrero MC.  Nefrologia. 2019 Jul - Aug;39(4):448-450. doi: 10.1016/j.nefro.2018.10.012.

Atorvastatin calcium trihydrate is the trihydrate form of atorvastatin calcium.

Take only under medical supervision. 

Atorvastatin, a member of the statin family and one of the statin class inhibitors, is a lipidic agent that lowers levels of 3-hydroxy-3-methylgutaryl-CoA (HMG-CoA) reductase, so as to reduce elevated level of low density lipoproteins (LDL) cholesterol and cardiovascular risk.

In addition to its anti-cholesterol properties, atorvastatin has been shown to suppress the proliferation of cancer cells and induce apoptosis (1) and also playing a role in immunosuppression, fighting inflammation (there is a close association between inflammation and tumor), preventing dementia.

However, it has a problem of scarce gastric solubility and low total bioavailability together with higher pre-system clearance.

It has also demonstrated an antifungal ability against Candida albicans in vivo and in vitro (2).

in this study atorvastatin demonstrated positive effects on erectile function after radical prostatectomy surgery (3).

It also limited the influenza virus to generate lipid droplets and greatly suppresses virus replication (4).

Like all drugs it can cause side effects. Always consult your doctor.

Atorvastatin studies

Molecular  Formula: C₆₆H₇₄CaF₂N₄O₁₃

Molecular Weight: 1209.4 g/mol

CAS:  344423-98-9  1035205-53-8  1574495-40-1

NACRES NA.24

Sinonimi:

• Totalip
• Torvast
• Calcium (3R,5R)-7-(2-(4-fluorophenyl)-5-isopropyl-3-phenyl-4-(phenylcarbamoyl)-1H-pyrrol-1-yl)-3,5-dihydroxyheptanoate trihydrate
• 1H-Pyrrole-1-heptanoic acid, 2-(4-fluorophenyl)-beta,delta-dihydroxy-5-(1-methylethyl)-3-phenyl-4-((phenylamino)carbonyl)-, calcium salt (2:1), trihydrate, (betaR,deltaR)-
• calcium (3R,5R)-7-[2-(4-fluorophenyl)-3-phenyl-4-(phenylcarbamoyl)-5-propan-2-ylpyrrol-1-yl]-3,5-dihydroxyheptanoate trihydrate
• calcium bis{(3R,5R)-7-[3-(anilinocarbonyl)-5-(4-fluorophenyl)-2-isopropyl-4-phenyl-1H-pyrrol-1-yl]-3,5-dihydroxyheptanoate} trihydrate

References___________________________________________________

(1)   Yuan Q, Dong CD, Ge Y, Chen X, Li Z, Li X, Lu Q, Peng F, Wu X, Zhao J, Liu K. Proteome and phosphoproteome reveal mechanisms of action of atorvastatin against esophageal squamous cell carcinoma. Aging (Albany NY). 2019 Nov 7;11. doi: 10.18632/aging.102402.

Abstract. Statins comprise a class of prescription drugs used for reducing cholesterol. Evidence has also showed that statins could reduce cancer incidence. However, the anti-tumor mechanism of statins has not been fully defined. Here, we found that atorvastatin inhibited proliferation of esophageal squamous cell carcinoma (ESCC) cells. The underlying mechanisms were explored by mass spectrometry. The proteome data revealed that atorvastatin inhibited the cAMP and Rap1 signal pathways, except for Ras signal pathway. Interestingly, phosphoproteome profiles suggested that ERKT185/Y187, CDK1T14, and BRAC1S1189 phosphorylation-mediated Th17 cell differentiation, Gap junction and the Platinum drug resistance pathway were down-regulated after atorvastatin treatment. The phosphorylation levels of ERKT185/Y187, CDK1T14 and BRAC1S1189 were confirmed by western blotting in KYSE150 cells. More importantly, atorvastatin suppresses ESCC tumor growth in PDX models. The molecular changes in tumor tissues were confirmed by immunohistochemistry. In conclusion, deep-proteome and phosphoproteome analysis reveal a comprehensive mechanism that contributes to atorvastatin's anti-tumor effect.

(2) Ajdidi A, Sheehan G, Abu Elteen K, Kavanagh K. Assessment of the in vitro and in vivo activity of atorvastatin against Candida albicans.  J Med Microbiol. 2019 Oct;68(10):1497-1506. doi: 10.1099/jmm.0.001065.

Abstract. Aim. The aim of this work was to characterize the response of Candida albicans to atorvastatin, and to assess its in vivo antifungal capability.Methodology. The effect of atorvastatin on the growth and viability of C. albicans was assessed. The ability of the statin to alter cell permeability was quantified by measuring amino acid and protein leakage. The response of C. albicans to atorvastatin was assessed using label-free quantitative proteomics. The in vivo antifungal activity of atorvastatin was assessed using Galleria mellonella larvae infected with C. albicans.Results. Atorvastatin inhibited the growth of C. albicans. The atorvastatin-treated cells showed lower ergosterol levels than the controls, demonstrated increased calcofluor staining and released elevated quantities of amino acids and protein. Larvae infected with C. albicans showed a survival rate of 18.1±4.2 % at 144 h. In contrast, larvae administered atorvastatin (9.09 mg kg-1) displayed a survival rate of 60.2±6.4 % (P<0.05). Label-free quantitative proteomics identified 1575 proteins with 2 or more peptides and 465 proteins were differentially abundant (P<0.05). There was an increase in the abundance of enzymes with oxidoreductase and hydrolase activity in atorvastatin-treated cells, and squalene monooxygenase (4.52-fold increase) and lanosterol synthase (2.84-fold increase) were increased in abundance. Proteins such as small heat shock protein 21 (-6.33-fold) and glutathione peroxidase (-2.05-fold) were reduced in abundance.Conclusion. The results presented here indicate that atorvastatin inhibits the growth of C. albicans and is capable of increasing the survival of G. mellonella larvae infected with C. albicans.

(3)   Siltari A, Riikonen J, Fode M, Murtola TJ. Effects of Preoperative Atorvastatin Treatment On Erectile Function After Radical Prostatectomy: Results From a Subgroup of ESTO1, a Randomized, Double-Blind, Placebo-Controlled Study. J Sex Med. 2019 Oct;16(10):1597-1605. doi: 10.1016/j.jsxm.2019.07.001

(4) Episcopio D, Aminov S, Benjamin S, Germain G, Datan E, Landazuri J, Lockshin RA, Zakeri Z. Atorvastatin restricts the ability of influenza virus to generate lipid droplets and severely suppresses the replication of the virus.   FASEB J. 2019 Aug;33(8):9516-9525. doi: 10.1096/fj.201900428RR.

Abstract. Influenza virus causes infected cells to generate large numbers of lipid droplets. Because the virus envelope contains substantial cholesterol, we applied atorvastatin (ATV) to Madin-Darby Canine Kidney cells before infecting them. Five micromolars ATV, within physiologic range, strongly (>95%) inhibits reproduction of influenza A as measured by PCR of viral RNA, plaque assay for viable virus, and production of virus nucleoprotein (NP). Inhibition of any of the following can suppress formation of lipid droplets (>-50%) but does not interfere with the production of NP: endoplasmic reticulum stress, autophagy, or production of reactive oxygen substances (ROS). We conclude that, regardless of whether this widely used statin, which is generally considered to be safe, can prevent infection or minimize its severity, inhibition of the 3-hydroxy-3-methylglutaryl-coenzyme A reductase pathway to protect against infection by influenza virus or to mitigate its severity warrants further exploration.-Episcopio, D., Aminov, S., Benjamin, S., Germain, G., Datan, E., Landazuri, J., Lockshin, R. A., Zakeri, Z. Atorvastatin restricts the ability of influenza virus to generate lipid droplets and severely suppresses the replication of the virus.