LDL-C reductions and goal attainment among naive statin users in the Netherlands: real life results^*

ABSTRACT

Objective: The effectiveness of statin therapy in a real life setting may differ from that in clinical trials, as physicians make non-randomised treatment decisions for patients with less uniform and possibly different characteristics. We therefore performed a study to compare the effectiveness of different statins and doses in routine clinical practice with respect to total serum cholesterol and LDL-cholesterol (LDL-C) reduction and goal attainment according to European guidelines on the prevention of cardiovascular disease (CVD).

Research design and methods: Naive statin users starting treatment in 2003 and 2004 with LDL-C measurements at baseline and between 30 and 365 days after start of treatment were extracted from the PHARMO database. During treatment with their initial statin dose LDL-C reduction and attainment of cholesterol goals were compared between different statins and doses.

Results: Of 2303 identified naive patients, approximately 30% were allocated to the high CVD-risk group. Average LDL-C reductions were 48%, 42%, 39%, and 32% at mean doses of 11 mg rosuvastatin, 17 mg atorvastatin, 22 mg simvastatin and 35 mg pravastatin, respectively. The proportion of patients attaining cholesterol goals was 75% for rosuvastatin, 68% for atorvastatin, 56% for simvastatin, and 42% for pravastatin. Dose comparisons showed greater LDL-C reduction and increased goal attainment for rosuvastatin 10 mg compared to other statins at most doses (adjusted p < 0.05).

Conclusions: In a real life setting, both LDL-C reduction and the proportion of patients attaining cholesterol goals appear to be significantly increased among users of rosuvastatin compared to other statins. These results confirm and extend reported clinical trial results to a real world setting.

Key words: :

• Cholesterol
• Goal attainment
• LDL-C reduction
• Statins

Acknowledgements

Declaration of interest: This research was funded by an unrestricted grant from AstraZeneca UK Ltd. Study design, collection of data, management, analysis and interpretation of the data, as well as preparation and review of the manuscript, were conducted by employees of the PHARMO Institute (EH, MvdL. and RH). EH had full access to the raw dataset, performed the independent statistical analyses, and takes responsibility for the integrity of the data and the accuracy of the data analysis. MH and JO’D, employees and shareholders of AstraZeneca, were involved with the design of the study, and contributed to interpretation of the data and review and approval of the manuscript. AS contributed to interpretation of the data and review of the manuscript from a clinical point of view without financial compensation.

Notes

* Previous presentations of the contents of this article have taken place at: the International Society for Pharmacoeconomics and Outcomes Research European congress, September 2006, Copenhagen; and at the Pharmaceutical Sciences World Congress,April 2007, Amsterdam, The Netherlands