LDL cholesterol levels after switch from atorvastatin to rosuvastatin

Abstract

Objective: Initial statin therapy may not always adequately reduce elevated low-density lipoprotein cholesterol (LDL-C) levels. Although alternative therapies are available, switching to another statin may be beneficial, especially for those at highest risk of cardiovascular disease and events. This study examined changes in LDL-C levels following a switch from 40/80 mg of atorvastatin (ATV) to 20/40 mg of rosuvastatin (RSV).

Methods: This retrospective cohort study used data from the MarketScan administrative claims databases linked to laboratory values. Patients with or at risk for atherosclerotic cardiovascular disease (ASCVD) who switched from ATV 40/80 mg to RSV 20/40 mg and had LDL-C values measured within 90 days before and 30–180 days after the switch were included. The change in LDL-C was quantified for each patient and summarized across all patients and within each switch pattern (e.g. ATV40 to RSV20).

Results: There was a significant mean (SD) decrease in LDL-C of 21% (30%) across the whole sample (N = 136) after switching from ATV to RSV. The greatest decrease occurred in patients who switched from ATV40 to RSV40 (N = 20; −29% [19%]; p < .001). Similar changes were observed overall and within each switch pattern when the analysis was limited to patients who were persistent on RSV in the post-switch period (N = 112; −24% [24%]; p < .001).

Conclusions: Switching from ATV to RSV was associated with a significant decrease in LDL-C among high-risk patients. Switching between these two high-intensity statins may offer a viable alternative to other treatment modifications aimed at lowering LDL-C in this population.

Keywords:

• Atorvastatin
• cardiovascular disease
• cholesterol
• rosuvastatin
• drug switching

This article is referred to by:

Strategies to achieve low-density lipoprotein cholesterol targets in high-risk patients

Transparency

Declaration of funding

This study was funded by AstraZeneca.

Author contributions: conception and design of the study: S.J.L., T.O., D.A.A., S.J.; analysis or interpretation of the data: S.J.L., T.O., D.A.A., E.M.-M., K.A.E., S.J.; drafting or revision of the manuscript: S.J.L., T.O., D.A.A., E.M.-M., K.A.E., S.J.; final approval of the manuscript for publication: S.J.L., T.O., D.A.A., E.M.-M., K.A.E., S.J.

Declaration of financial/other relationships

S.J.L. has disclosed that she has had travel expenses paid by AstraZeneca and has received honoraria from Amgen. T.O. and D.A.A. have disclosed that they are full-time employees of AstraZeneca. E.M.-M. and K.A.E. have disclosed that they are full-time employees of Truven Health Analytics, and S.J. has disclosed that he is a former employee of Truven Health Analytics, which was paid by AstraZeneca to conduct this study.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

The authors would like to thank Dr. Shaswati Khan (Truven Health Analytics, an IBM Company) for assistance in medical writing.