การเปรียบเทียบประสิทธิผลและความปลอดภัยของยาซิมวาสทาทิน 10 มิลลิกรัม ที่ให้ในเวลาเช้ากับเวลาเย็นในผู้ป่วยนอกสูงอายุ / ณัฐติพร สรรพกิจกำจร = Comparison of efficacy and safety between morning and evening dosing of 10-MG simvastatin in geriatric outpatients / Nattiporn Sappakitkumjorn
Simvastatin is widely used in patients with dyslipidemia. No study was carried out to determine the effects of the drug taken by Thai geriatric patients in the morning and the evening. This research was aimed to compare the efficacy, safety and drug compliance of geriatric outpatients who took 10-mg simvastatin between morning and evening doses. A randomized, open-label, parallel clinical trial was conducted at the Geriatric Clinic, Phramongkutklao Hospital. The geriatric outpatients were chosen based on eligible criteria and randomly allocated to four groups: Groups 1 (control group) and 3 taking simvastatin in the morning, and Groups 4 (control group) and 2 receiving the drug in the evening. All data were collected at weeks 0 and 12 during September 2004 March 2005. The results showed that a total of 80 patients were 43 females and 37 males with the age of 73.7+-7.0 years. Most patients (96.2%) used 10-mg simvastatin for primary prevention of coronary heart disease. At week 0, patient's characteristics, comorbid diseases, concurrent medications, risk factors of coronary heart disease, targeted LDL-C levels, and blood lipid profiles (i.e., LDL-C, TC, HDL-C, and TG) were not statistically different among the four patients groups (p>0.05). When comparing the efficacy of simvastatin taken different time at week 12, no statistical difference was found in terms of blood lipid profiles and targeted LDL-C levels. Within each group, the percentages of mean lipid change between weeks 0 and 12 were slightly reported. The mean levels of LDL-C, TC, HDL-C, and TG were changed from -6.5% to +3.8%, -4.9% to -0.4%, -0.4% to +5.3%, and -4.5% to +15.6%, respectively, which were not clinically important. Regarding the drug safety and compliance of the four groups at week 12, the number of patients with adverse events and the number of times that patients forgot to take simvastatin were not statistically significant (p>0.05). As guidelines for geriatric patients at Phramongkutklao Hospital, morning and evening dosing of 10-mg simvastatin would be equally effective, safe, and improve patients drug compliance. Further studies are required to determine the effects of simvastatin with several doses or in different groups of patients in order to utilize the drug properly