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Rosuvastatin Provides Better Rates of Lipid Lowering Compared to Other Statins: Presented at DALM

By Chris Berrie

VENICE, ITALY -- October 27, 2004 -- Switching to rosuvastatin from comparator statins appears to be a good strategy for improving target lipid levels in patients who require cholesterol-lowering therapy, including those patients who are at high risk of coronary artery disease.

In the multinational, 16-week, randomised, open-label, 5-arm, parallel-group study, Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapy (MERCURY I), switching to rosuvastatin from another statin agent helped more patients achieve primary treatment goals for low-density lipoprotein cholesterol (LDL-C) and secondary apolipoprotein (apo) B treatment goals in coronary heart disease (CHD) patients with high lipid levels.

Philip Barter, MD, PhD, executive committee investigator and director, Heart Research Institute, Sydney, Australia, presented the findings on behalf of the MERCURY I Trialist Group here on October 26th at the XV International Symposium on Drugs Affecting Lipid Metabolism.

Dr. Barter said that the study was designed to compare the effects of rosuvastatin at a dose of 10 mg or 20 mg and the commonly used doses of other statins in relation to particular goals in hypercholesterolaemic patients.

"Although it is not yet part of the primary guidelines, the main purpose here was to look at the [National Cholesterol Education Program Adult Treatment Panel] ATP III goals and the ability to achieve apo B targets," Dr. Barter added. "And the reason for this is that there is a progressive recognition that apo B may turn out to be a better predictor of coronary events."

The MERCURY I study enrolled 3140 adults with hypercholesterolaemia and CHD, atherosclerosis, or type 2 diabetes, and fasting LDL-C levels of 115 mg/dL or greater. Following a 6-week dietary lead-in phase, there was an 8-week treatment period, with patients randomised to receive rosuvastatin 10 mg (RSV10), atorvastatin 10 mg (ATV10), atorvastatin 20 mg (ATV20), simvastatin 20 mg (SMV20), and pravastatin 40 mg (PRV40).

At the end of the treatment period, patients either continued their treatment or switched to RSV10 (including RSV20 in the case of ATV20) for the next 8 weeks, forming the group series of: RSV10/10, ATV10/10, ATV10/RSV10, ATV20/20, ATV20/RSV10, ATV20/RSV20, SMV20/20, SMV20/RSV10, PRV40/40, and PRV40/RSV10.

According to the ATP III goals, the LDL-C and apo B treatment goals used for the low-, medium-, and high-risk patient groups were < 160 mg/dL, < 130 mg/dL, and < 100 mg/dL for LDL-C, respectively, and < 130 mg/dL, < 110 mg/dL, and < 90 mg/dL for apo B, respectively.

All risk categories were combined for this analysis, and expressed as the percentage of patients who achieved LDL-C goal at week 16, and the percentage that achieved the combined LDL-C plus apo B goals at week 16.

In terms of LDL-C goal and combined LDL-C/apo B goals, respectively, the continued single-statin treatment goal achievements were: RSV10/10, 79%, 50%; ATV10/10, 69%, 34%; ATV20/20, 74%, 46%; SMV20/20, 60%, 29%; PRV40/40, 50%, 24%.

In comparison with the goal achievements for the equivalent single dose continuations, all of the groups that switched to RSV had better goal achievements, which reached a significance of P <.001 (for LDL-C goal and combined LDL-C/apo B goals, respectively): ATV10/RSV10, 79%, 49%; ATV20/RSV20, 86%, 62%; SMV20/RSV10, 75%, 45%; PRV40/RSV10, 80%, 53%.

Over the full 16 weeks, all of the treatments were well tolerated, with similar adverse event type and occurrence rates among all the treatment groups. There were no cases of myopathy.

Thus, Dr. Barter confirmed that over the full 16 weeks of this study, switching to rosuvastatin allowed more patients to achieve their primary LDL-C and secondary total apo B treatment goals, including those patients at high risk of coronary artery disease.


[Presentation title: Achievement of Apolipoprotein B Goal in Patients Who Achieve Their Low-Density Lipoprotein Cholesterol Goal: Results of the MERCURY I Trial. Poster 69]

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