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Pitavastatin (cancer chemoprevention context; statin class proxy)

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDDRUG-PITAVASTATIN-CHEMOPREVENTION
TypeDrug
Aliases
LivaloLivazoPitavaPitavastatin (cancer chemoprevention)Statin (pitavastatin proxy)Пітавастатин (хіміопрофілактика раку; представник статинів)
Statusreviewed 2026-05-18 | pending_clinical_signoff
DiseasesNone declared
SourcesSRC-NCCN-BCELL-2025 SRC-WCRF-AICR-CUP-2018

Drug Facts

ClassHMG-CoA reductase inhibitor (statin) — lipophilic, third-generation, low-CYP profile
MechanismLipophilic third-generation statin with low-dose potency similar to atorvastatin. Active form (not a prodrug). Cancer-prevention rationale: shared statin pleiotropic effects (decreased isoprenoid prenylation of Ras/Rho, anti-inflammatory, antiproliferative, pro-apoptotic). Minimally metabolized by CYP enzymes (mostly UGT-mediated lactonization with enterohepatic recirculation), giving a cleaner DDI profile than simvastatin/atorvastatin. Cancer-prevention RCT-level evidence is ABSENT — pitavastatin trial portfolio is too small to detect cancer- incidence effects. Primary regulatory indication is cardiovascular risk reduction; in HIV-population CV-prevention (REPRIEVE 2023) — does not inhibit antiretrovirals.
Typical dosingCardiovascular-prevention dosing range: 1-4 mg PO once daily (with or without food, any time of day). Typical starting dose 2 mg/day; titrate per LDL target. No specific oncology-prevention dose. CrCl 15-59: start 1 mg, max 2 mg/day. End-stage renal disease on HD: max 2 mg/day. Hepatic monitoring (baseline LFTs); CK only if symptomatic.
Ukraine registeredFalse
NSZU reimbursedFalse
Ukraine last verified2026-05-18

Notes

STUB — v0.2 chemoprevention-workstream authoring (batch 3); pending two- Clinical-Co-Lead signoff per CHARTER §6.1 dev-mode. STATIN CLASS-DETAIL entity. Primary clinical use remains cardiovascular; niche application is HIV patients on antiretrovirals (REPRIEVE trial 2023 — pitavastatin reduces MACE in HIV+ adults with low-to-moderate CV risk; clean DDI profile with most ART regimens including INSTI + TAF). Cancer-incidence signals from observational meta-analyses are limited (insufficient exposure-time in pivotal trials). Engine should NOT recommend statin initiation for cancer prevention. Limited availability in Ukraine — engine should not surface this option for UA-resident patients without confirming pharmacy availability.

Used By

No reverse references found in the YAML corpus.