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Rosuvastatin Lowers Cholesterol Most in Metabolic Syndrome Patients: Presented at ACC

By Ed Susman

NEW ORLEANS, LA -- March 10, 2004 -- In a comparison of 4 cholesterol-lowering drugs, rosuvastatin (Crestor) resulted in the greatest reductions in low-density lipoprotein (LDL) cholesterol, researchers reported here March 8^th at the American College of Cardiology 53^rd Annual Scientific Sessions.

"Not only was it more effective than atorvastatin, simvastatin and pravastatin in lowering LDL," said Prakash Deedwania, MD, Chief of the Cardiology Section, University of California, San Francisco at Fresno. "But rosuvastatin also was better than the other statins in raising high density lipoprotein [HDL] cholesterol and in lowering triglycerides."

In the Statin Therapies for Elevated Lipid Levels Compared Across Doses to Rosuvastatin (STELLAR) study, rosuvastatin in doses of 10 mg, 20 mg and 40 mg, was compared to pravastatin 10 mg, 20 mg and 40 mg; simvastatin 10 mg, 20 mg, 40 mg and 80 mg; and atorvastatin 10 mg, 20 mg, 40 mg and 80 mg.

The 6-week study had 14 arms, and looked at how well the drugs could reduce cholesterol levels and impact other lipids in 811 patients who had 3 or more conditions associated with what is now known as the cardiovascular metabolic syndrome, Dr. Deedwania said.

The cardiovascular metabolic syndrome is characterized by abdominal obesity, high levels of triglycerides, low HDL cholesterol, elevated blood pressure and insulin resistance.

In his oral presentation, he reported that across the dosing ranges rosuvastatin reduced non-HDL cholesterol levels between 40% and 52% compared to 34% to 46% for atorvastatin, 26% to 42% with simvastatin, and 19% to 27% with pravastatin. The reductions seen with rosuvastatin reached significance when compared with all doses of pravastatin and simvastatin, and against atorvastatin 20 mg (P = .002).

Dr. Deedwania said that the increases in HDL cholesterol ranged from 7.6% to 10.4% with rosuvastatin, 4.7% to 9.4% with atorvastatin, 8.3% to 10.0% with simvastatin, and 3.3% to 6.4% for pravastatin.

From a mean triglyceride level of 215 mg/dL, marker of the metabolic syndrome fell from 22% to 34% with rosuvastatin, 22% to 33% with atorvastatin, 15% to 23% with simvastatin, 12% to 15% with pravastatin.

"The increasing prevalence of the metabolic syndrome means that clinicians are having to meet new management challenges," Dr. Deedwania said, "and while it is important to focus on therapeutic lifestyle changes, we need a treatment that effectively targets the atherogenic dyslipidemia seen in patients with the syndrome."

The results seen in data gleaned from the study, he said, "are encouraging because they show that with Crestor, we have a treatment that is highly effective at helping to correct the underlying lipid abnormalities associated with the metabolic syndrome."

Crestor is marketed by AstraZeneca, the company that funded the trial.


[Study title: Comparative Effects of Statins on Atherogenic Dyslipidemia in Patients With the Metabolic Syndrome. Abstract 820-1]

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