Effectiveness of rosuvastatin in reducing LDL-C and target LDL-C goal attainment in real-world clinical practice

Abstract

Objective:

This article reviewed the collective evidence from routine clinical practice to summarize the existing literature on the effectiveness of rosuvastatin in treating hypercholesterolemia.

Methods:

A comprehensive Medline literature search identified all published articles, in all languages, from January 2003 through September 2008 on the use of rosuvastatin in the usual-care setting. The search identified 60 articles, and 16 articles were included in this review because they were observational and non-interventional and included sufficient data specific to rosuvastatin. Excluded articles were clinical trials, cost-effectiveness models, safety, reviews, pharmacokinetics, abstracts or editorials only, or all statins combined. Included rosuvastatin articles were categorized as (1) effectiveness in general population and (2) effectiveness in special populations (e.g., elderly, diabetes).

Results:

Seven studies consistently showed that diverse patients from different geographic regions who were newly initiated on rosuvastatin had significantly greater reduction in low-density lipoprotein cholesterol (LDL-C) (29–52%) compared with patients treated with other statins (16–43%). LDL-C goal attainment as recommended by National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III or European Society of Cardiology (ESC) guidelines was consistently and significantly higher among patients treated with rosuvastatin (64–81%) compared with patients treated with other statins (34–73%). Rosuvastatin-treated patients with diabetes or HIV or who were elderly had significantly greater LDL-C reduction and LDL-C goal attainment compared with patients treated with other statins.

Limitations:

Channeling bias or confounding by indication may have influenced the results of the real-world studies, if physicians reserve rosuvastatin for sicker or more difficult to treat patients.

Conclusions:

There is a strong and consistent body of evidence demonstrating the effectiveness of rosuvastatin in lowering LDL-C and LDL-C goal attainment in real life compared with other statins at commonly prescribed doses, which reflects the existing evidence from clinical trials.

Key words::

• Clinical practice
• LDL-C
• Real-world study
• Rosuvastatin
• Statin effectiveness

Transparency

Declaration of funding

This research was supported by AstraZeneca Pharmaceuticals LP.

Declaration of financial/other relationships

K.J., S.K.G. and G.B-W. have disclosed that they are employees and stockholders of AstraZeneca. K.F. has disclosed that she has received research funds from AstraZeneca.

S.K.G. has disclosed that he made significant contributions to the concept and design of the research, data and statistical interpretation; critical review of the article; and approval of the article. K.J. has disclosed that he made significant contributions to the design of the research, data interpretation, critical review of the article, and approval of the article. K.F. has disclosed that she made significant contributions to the design of the research; data analysis, data and statistical interpretation; drafting and approval of the article. She also has disclosed that she has received grants from AstraZeneca to conduct this research study. G.B-W. has disclosed that he provided significant contributions to the clinical focus and interpretation; data interpretation; critical review of, and approval of the article. The sponsor did not have any involvement in the study design, data analysis, manuscript preparation or publication decision other than through the authors.

Some peer reviewers receive honoraria from CMRO for their review work. Peer reviewer 1 has disclosed that he/she was on the speakers’ bureau of Pfizer, Caduet. The other peer reviewer has no relevant financial relationships.

Acknowledgment

The authors have disclosed that they had no outside editorial assistance in preparing this manuscript.