Effects of Rosuvastatin and Atorvastatin Compared Over 52 Weeks
Background: Despite the demonstrated benefits of low-density lipoprotein cholesterol (LDL-C) reduction in reducing the risk of coronary heart disease, many patients receiving lipid-lowering therapy fail to achieve LDL-C goals. We compared the effects of rosuvastatin and atorvastatin in reducing LDL-C and achieving LDL-C goals in patients with primary hypercholesterolemia.
Methods and Results: In this 52-week, randomized, double-blind, multicenter trial (4522IL/0026), 412 patients with LDL-C 160 to <250 mg/dL received a 5-mg dose of rosuvastatin (n = 138), a 10-mg dose of rosuvastatin (n = 134), or a 10-mg dose of atorvastatin (n = 140) for 12 weeks; during the following 40 weeks, dosages could be sequentially doubled up to 80 mg if National Cholesterol Education Program Adult Treatment Panel II (ATP-II) LDL-C goals were not achieved. At 12 weeks, 5- and 10-mg doses of rosuvastatin were associated with significantly greater LDL-C reductions than 10-mg doses of atorvastatin (46% and 50% vs 39%, both P < .001). At 12 weeks, both rosuvastatin dosages brought more patients to within ATP-II and European LDL-C goals than atorvastatin (86% and 89% vs 73% and 75%, and 86% vs 55%, respectively). At 52 weeks, compared with atorvastatin, both initial rosuvastatin treatment groups significantly reduced LDL-C (47% and 53% vs 44%, P < .05 and P < .001). Overall, more patients in the initial rosuvastatin 10-mg group achieved their ATP-II LDL-C goal than those in the initial atorvastatin 10-mg group (98% vs 87%), with 82% of patients treated with rosuvastatin achieving their goal at the 10-mg starting dosage without the need for titration, compared with 59% of patients treated with atorvastatin. Both treatments were well tolerated over 52 weeks.
Conclusion: Compared with atorvastatin, rosuvastatin produced greater reductions in LDL-C, which may offer advantages in LDL-C goal attainment over existing lipid-lowering therapies.
Despite the demonstrated benefits of low-density lipoprotein cholesterol (LDL-C) reduction in reducing the risk of coronary heart disease (CHD), many patients receiving lipid-lowering therapy fail to achieve LDL-C levels recommended by current guidelines. This is primarily due to less than optimal treatment strategies aimed at achieving LDL-C goals. Nevertheless, treatment in clinical practice may benefit from the availability of more efficacious agents that could, at starting doses, promptly reduce LDL-C to target levels across risk strata. Rosuvastatin (Crestor, AstraZeneca, Macclesfield, Cheshire, United Kingdom; licensed from Shionogi & Co, Ltd, Osaka, Japan) is a new synthetic statin with pronounced LDL-C-lowering effects. In a dose-ranging program, rosuvastatin produced dose-dependent mean reductions in LDL-C up to 65% at 80 mg per day. Atorvastatin (Lipitor, Pfizer, New York, NY) is considered to be the most efficacious statin currently available. Therefore, we compared the effects of rosuvastatin and atorvastatin in reducing LDL-C and achieving international LDL-C goals in patients with primary hypercholesterolemia over 12 weeks of fixed-dose treatment (5 and 10 mg of rosuvastatin vs 10 mg of atorvastatin) and 40 weeks of dose titration aimed at goal achievement.
Background: Despite the demonstrated benefits of low-density lipoprotein cholesterol (LDL-C) reduction in reducing the risk of coronary heart disease, many patients receiving lipid-lowering therapy fail to achieve LDL-C goals. We compared the effects of rosuvastatin and atorvastatin in reducing LDL-C and achieving LDL-C goals in patients with primary hypercholesterolemia.
Methods and Results: In this 52-week, randomized, double-blind, multicenter trial (4522IL/0026), 412 patients with LDL-C 160 to <250 mg/dL received a 5-mg dose of rosuvastatin (n = 138), a 10-mg dose of rosuvastatin (n = 134), or a 10-mg dose of atorvastatin (n = 140) for 12 weeks; during the following 40 weeks, dosages could be sequentially doubled up to 80 mg if National Cholesterol Education Program Adult Treatment Panel II (ATP-II) LDL-C goals were not achieved. At 12 weeks, 5- and 10-mg doses of rosuvastatin were associated with significantly greater LDL-C reductions than 10-mg doses of atorvastatin (46% and 50% vs 39%, both P < .001). At 12 weeks, both rosuvastatin dosages brought more patients to within ATP-II and European LDL-C goals than atorvastatin (86% and 89% vs 73% and 75%, and 86% vs 55%, respectively). At 52 weeks, compared with atorvastatin, both initial rosuvastatin treatment groups significantly reduced LDL-C (47% and 53% vs 44%, P < .05 and P < .001). Overall, more patients in the initial rosuvastatin 10-mg group achieved their ATP-II LDL-C goal than those in the initial atorvastatin 10-mg group (98% vs 87%), with 82% of patients treated with rosuvastatin achieving their goal at the 10-mg starting dosage without the need for titration, compared with 59% of patients treated with atorvastatin. Both treatments were well tolerated over 52 weeks.
Conclusion: Compared with atorvastatin, rosuvastatin produced greater reductions in LDL-C, which may offer advantages in LDL-C goal attainment over existing lipid-lowering therapies.
Despite the demonstrated benefits of low-density lipoprotein cholesterol (LDL-C) reduction in reducing the risk of coronary heart disease (CHD), many patients receiving lipid-lowering therapy fail to achieve LDL-C levels recommended by current guidelines. This is primarily due to less than optimal treatment strategies aimed at achieving LDL-C goals. Nevertheless, treatment in clinical practice may benefit from the availability of more efficacious agents that could, at starting doses, promptly reduce LDL-C to target levels across risk strata. Rosuvastatin (Crestor, AstraZeneca, Macclesfield, Cheshire, United Kingdom; licensed from Shionogi & Co, Ltd, Osaka, Japan) is a new synthetic statin with pronounced LDL-C-lowering effects. In a dose-ranging program, rosuvastatin produced dose-dependent mean reductions in LDL-C up to 65% at 80 mg per day. Atorvastatin (Lipitor, Pfizer, New York, NY) is considered to be the most efficacious statin currently available. Therefore, we compared the effects of rosuvastatin and atorvastatin in reducing LDL-C and achieving international LDL-C goals in patients with primary hypercholesterolemia over 12 weeks of fixed-dose treatment (5 and 10 mg of rosuvastatin vs 10 mg of atorvastatin) and 40 weeks of dose titration aimed at goal achievement.
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