Source: DGNews  |  Posted 8 years ago

By Eurona Earl Tilley

KYOTO, JAPAN -- October 1, 2003 -- Rosuvastatin is significantly more effective than atorvastatin, simvastatin, and pravastatin in improving the ratios of total cholesterol to high-density lipoprotein cholesterol (TC:HDL), low-density lipoprotein to high density lipoprotein cholesterol (LDL:HDL), and non-high density lipoprotein to high density lipoprotein (non-HDL:HDL), according to results of a 6-week trial.

"Plasma lipid ratios, such as TC:HDL, LDL:HDL, and non-HDL:HDL, have previously been shown to be indicative of the development of coronary artery disease (CAD)," said Evan A. Stein, MD, Medical Research Laboratories International, Highland Heights, Kentucky, United States. He presented the findings here September 30th at the 13th International Symposium on Atherosclerosis.

Dr. Stein and colleagues evaluated the lipid ratios in adults with a mean age of 58 years from 182 medical centres in the United States. Each participant had a LDL-C between 160 mg/dl and 250 mg/dl as well as a triglyceride level under 400 mg/dl. Atherosclerosis and/or diabetes was present in 25% of the patients.

Following a 6-week dietary lead in period, during which time the use of all lipid-lowering drugs and supplements was suspended, each participant was randomly placed in 1 of 15 therapy groups with 154 to 165 patients per group. They received 1 of the following oral regimens: rosuvastatin 10 mg/day, 20 mg/day, 40 mg/day, or 80 mg/day; atorvastatin 10 mg/day, 20 mg/day, 40 mg/day, or 80 mg/day; simvastatin 10 mg/day, 20 mg/day, 40 mg/day, or 80 mg/day; pravastatin 10 mg/day, 20 mg/day, or 40 mg/day.

Adverse effects included pain, pharyngitis, myalgia, and headache in a similar percentage of patients among each treatment group.

At the end of treatment, TC:HDL ratios were decreased by 37% to 45% in the rosuvastatin 10 mg to 40 mg groups, 31% to 40% in the atorvastatin groups, 24% to 37% in the simvastatin groups, and 17% to 25% in the pravastatin groups.

LDL:HDL ratios were similarly decreased by 49% to 58% in the rosuvastatin 10 mg to 40 mg groups, 40% to 52% in the atorvastatin groups, 32% to 49% in the simvastatin groups, and 22% to 33% in the pravastatin groups.

A reduction in the non-HDL:HDL ratios of 46% to 55%, 38% to 48%, 29% to 45%, and 21% to 31% was demonstrated in the rosuvastatin, atorvastatin, simvastatin, and pravastatin groups respectively. The data from the rosuvastatin 80 mg group could not be included since this dosage was determined to be unsafe by a Federal Drug Administration advisory committee.

Dr. Stein concluded that lipid ratios are the best predictor of adverse cardiac events, and it is important to note that rosuvastatin, in doses between 10 mg and 40 mg, had the most favourable effect on these ratios.

[Study title: Rosuvastatin Compared With Atorvastatin, Simvastatin, and Pravastatin for Lipid Ratios (STELLAR Trial Results). Abstract 2P-0586]