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New Superiority Trial Showed LIVALO® (pitavastatin) 4 mg Provided Significantly Greater LDL-C Reduction in HIV-Infected Adults with Dyslipidemia versus Pravastatin 40 mg

Study results presented today as late-breaker at CROI 2013


Atlanta, GA, March 7, 2013 – Kowa Pharmaceuticals America, Inc. and Eli Lilly and Company (NYSE:LLY) today announced results of a study evaluating the efficacy of LIVALO® (pitavastatin) 4 mg compared with pravastatin 40 mg in reducing low-density lipoprotein cholesterol (LDL-C) in HIV-infected adults with high cholesterol, or dyslipidemia. The study was designed as a superiority trial for the primary endpoint, percent reduction in LDL-C, and evaluated HIV-infected adults with dyslipidemia; with and without viral Hepatitis B or C. The study met its primary endpoint.1

Results showed that, after 12 weeks of therapy, pitavastatin had a significantly greater decrease in LDL-C compared with pravastatin (pitavastatin -49.4 mg/dL and pravastatin -33.6 mg/dL, 31% vs 21% reduction in LDL-C, respectively, p<0.001). The results were presented at a latebreaking poster presentation today at the 20th Conference on Retroviruses & Opportunistic Infections (CROI) in Atlanta, GA.1

Dyslipidemia is common in people with HIV infection.2 HIV-infected adults are at an increased risk for cardiovascular disease due to many factors, including lipid abnormalities.3

"We are pleased that the study objective was met, showing superiority of pitavastatin 4 mg to pravastatin 40 mg on LDL-C reduction in HIV-infected adults with dyslipidemia, and we lookforward to further analysis of these data," said Dr. Craig Sponseller, Vice President of Medical Affairs, Kowa Pharmaceuticals America, Inc."

Study investigator, Dr. Judith Aberg, Director of Virology, Bellevue Hospital Center and Director, Division of Infectious Diseases and Immunology, NYU School of Medicine, said, "In HIV-infected patients with high cholesterol, data such as these represent an important step in understanding lipid management in this immunocompromised patient population."

The overall incidence of treatment emergent adverse events (TEAEs) was 61.1% for pitavastatin and 62.7% for pravastatin. The most frequently reported TEAEs overall (in ≥2% of subjects in either treatment group) included diarrhea (13 subjects, 5.2%), upper respiratory tract infection (13 subjects, 5.2%), sinusitis (12 subjects, 4.8%), headache (10 subjects, 4.0%), nausea (10 subjects, 4.0%), nasopharyngitis (9 subjects, 3.6%), and blood creatine phosphokinase increased (8 subjects, 3.2%). Eleven subjects were discontinued from the study due to a TEAE (4.4%).1

About the Study
In the 12-week, Phase 4, randomized (1:1), double-blind, double-dummy, active-controlled, parallel-group study, 252 patients were randomized to receive once-daily doses of pitavastatin 4 mg or pravastatin 40 mg. The primary efficacy analysis (ANCOVA) used percent change in LDL-C as the dependent variable, and treatment, site, and viral hepatitis B or C infection as independent variables. The major secondary lipid endpoints assessed were total cholesterol, HDL-C, non-HDL-C and triglycerides. Safety assessments included adverse events, clinical/laboratory tests, HIV-1 RNA, CD4 count, and virologic failure.1

LIVALO is a HMG-CoA reductase inhibitor indicated as an adjunctive therapy to diet to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG), and to increase high-density lipoprotein cholesterol (HDL-C) in adult patients with primary hyperlipidemia or mixed dyslipidemia.

Limitations of Use:

In addition to being launched in the U.S. in June 2010, LIVALO has been approved in Japan and 32 other countries as of January 2013.

Primary Hyperlipidemia and Mixed Dyslipidemia
Primary hyperlipidemia is defined as an elevation of cholesterol, particularly "bad" cholesterol (LDL-C), triglycerides (TG), or both. Mixed dyslipidemia is usually characterized by an elevation of LDL-C, TG, and a decrease in the "good" cholesterol (HDL-C) in the blood.


LIVALO is contraindicated in patients with a known hypersensitivity to product components, in patients with active liver disease (which may include unexplained persistent elevations in hepatic transaminase levels), in women who are pregnant or may become pregnant, in nursing mothers, or in co-administration with cyclosporine.


Skeletal Muscle Effects
Cases of myopathy and rhabdomyolysis with acute renal failure secondary to myoglobinuria have been reported with HMG-CoA reductase inhibitors, including LIVALO. These risks can occur at any dose level, but increase in a dose-dependent manner.

Liver Enzyme Abnormalities
Increases in serum transaminases have been reported with HMG-CoA reductase inhibitors, including LIVALO.

Endocrine Function
Increases in HbA1c and fasting serum glucose levels have been reported with HMG-CoA reductase inhibitors, including LIVALO.


In short-term controlled studies, the most frequent adverse reactions reported by ≥2% of patients treated with LIVALO 1 mg, 2 mg, and 4 mg, respectively, and at a rate ≥ placebo were back pain (3.9%, 1.8%, 1.4% vs 2.9%), constipation (3.6%, 1.5%, 2.2% vs 1.9%), diarrhea (2.6%, 1.5%, 1.9% vs 1.9%), myalgia (1.9%, 2.8%, 3.1% vs 1.4%), and pain in extremity (2.3%, 0.6%, 0.9% vs 1.9%). This is not a complete listing of all reported adverse events.

For additional information please see the full Prescribing Information provided, or visit
LIV-RA-0058 PS82458 1/2013

About Kowa Company, Ltd. and Kowa Pharmaceuticals America, Inc.
Kowa Company, Ltd. (KCL) is a privately held multinational company headquartered in Nagoya, Japan. Established in 1894, KCL is actively engaged in various manufacturing and commercial activities in the fields of pharmaceutical, life science, information technology, textiles, machinery and various consumer products. KCL’s pharmaceutical division is focused on cardiovascular therapeutics, with sales of the company’s flagship product LIVALO, totaling $567 million in Japan in 2012, and was launched in the United States in June 2010.

Kowa Pharmaceuticals America, Inc. (KPA) is a pharmaceutical company specializing primarily in the area of cardiometabolic diseases. The company, started in 2001 as ProEthic Pharmaceuticals, Inc., was acquired by KCL in September of 2008. A privately held company, KPA directs its efforts towards the acquisition, licensing and marketing of pharmaceutical products.

exchange rate used $1=90JPY

About Eli Lilly and Company
Lilly, a leading innovation-driven corporation, is developing a growing portfolio of pharmaceutical products by applying the latest research from its own worldwide laboratories and from collaborations with eminent scientific organizations. Headquartered in Indianapolis, Ind., Lilly provides answers – through medicines and information – for some of the world's most urgent medical needs. Additional information about Lilly is available at P-LLY

This press release contains certain forward-looking statements about LIVALO®, a HMG-CoA reductase inhibitor indicated as an adjunctive therapy to diet to reduce elevated total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), apolipoprotein B (Apo B), triglycerides (TG), and to increase high-density lipoprotein cholesterol (HDL-C) in adult patients with primary hyperlipidemia or mixed dyslipidemia. This release reflects Lilly and Kowa’s current beliefs; however, as with any pharmaceutical product, there are substantial risks and uncertainties in the process of development and commercialization. There is no guarantee that future study results and patient experience will be consistent with study findings to-date or that LIVALO will be commercially successful. For further discussion of these and other risks, see Lilly’s filings with the United States Securities and Exchange Commission. Lilly undertakes no duty to update forward-looking statements.

LIVALO is a registered trademark of the Kowa group of companies.




1 Data on File: Sponseller C, Morgan R, Campbell S, et al. Pitavastatin 4 mg Provides Greater LDL-C Reduction Compared to Pravastatin 40 mg over 12 weeks of Treatment in HIV-infected Adults with Dyslipidemia. Poster presented at the 20th Conference on Retroviruses & Opportunistic Infections, March 3-6, 2013; Atlanta, GA.

2 Boccara F. Lang S, Meuleman C, et al. HIV and Coronary Heart Disease. Journal of the American College of Cardiology. 2013; 61(5):511-523. <p511/1>.

3 Malvestutto CD, Aberg JA. Management of dyslipidemia in HIV-infected patients. Journal of Clinical Lipidology. 2011; 6(4):447-462. <p447, 1; p448, col1, 4>

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