Skip to main content
Top
Published in: American Journal of Cardiovascular Drugs 4/2008

01-07-2008 | Original Research Article

Effects of Low-Dose Atorvastatin and Rosuvastatin on Plasma Lipid Profiles

A Long-Term, Randomized, Open-Label Study in Patients with Primary Hypercholesterolemia

Authors: Dr Fabio Mazza, Claudia Stefanutti, Serafina Di Giacomo, Antonio Vivenzio, Nadia Fraone, Bruno Mazzarella, Antonello Bucci

Published in: American Journal of Cardiovascular Drugs | Issue 4/2008

Login to get access

Abstract

Background and objective

Despite the favorable effects of reduction of low-density lipoprotein-cholesterol (LDL-C) levels in decreasing the risk of coronary heart disease, many patients treated with lipid-lowering HMG-CoA reductase inhibitors (statins) do not achieve goal LDL-C levels. This may be due to high doses of statins prescribed that could potentially induce adverse effects and compromise patient safety and compliance with considerable expense in the long-term. We compared the actions of rosuvastatin and atorvastatin, administered at the low dosages of 10 and 20 mg/day, respectively, in reducing plasma LDL-C levels and their effects on other components of the atherogenic lipid profile in patients with primary hypercholesterolemia.

Methods

In this randomized, parallel group, open-label clinical study, 106 patients with LDL-C >200 mg/dL were treated with rosuvastatin 10 mg/day (group A; n = 52), or atorvastatin 20 mg/day (group B; n = 54) for 48 weeks.

Results

At 48 weeks, rosuvastatin 10 mg/day was associated with a significantly greater reduction in plasma LDL-C levels compared with atorvastatin 20 mg/day (−44.32% vs −30%; p < 0.005). Compared with atorvastatin, rosuvastatin also produced a greater reduction in plasma total cholesterol, triglycerides, and non-high-density lipoprotein-cholesterol (non-HDL-C) levels (p < 0.005). Plasma HDL-C levels were not affected significantly, independent of the drug used.

Conclusion

In high-risk patients with primary hypercholesterolemia, rosuvastatin 10 mg/day was more efficacious than atorvastatin 20 mg/day in reducing plasma LDL-C levels, enabling goal LDL-C levels to be achieved and improving other lipid parameters. Both treatments were well tolerated over 48 weeks.
Literature
1.
go back to reference Grundy SM, Cleeman JI, Merz CN, et al. Implication of recent clinical trials for the National Cholesterol Education Program Adult Treatment panel III guidelines [published erratum appears in Circulation 2004;l10 (6):763]. Circulation 2004; 110: 227–39PubMedCrossRef Grundy SM, Cleeman JI, Merz CN, et al. Implication of recent clinical trials for the National Cholesterol Education Program Adult Treatment panel III guidelines [published erratum appears in Circulation 2004;l10 (6):763]. Circulation 2004; 110: 227–39PubMedCrossRef
2.
go back to reference Expert Panel on Detection Evaluation and treatment of High Blood Cholesterol in Adults. Executive Summary of the Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatments Panel III). JAMA 2001; 285: 2486–97.CrossRef Expert Panel on Detection Evaluation and treatment of High Blood Cholesterol in Adults. Executive Summary of the Third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatments Panel III). JAMA 2001; 285: 2486–97.CrossRef
3.
go back to reference Sever PS, Dhalof B, Poulter NR, et al., on behalf of the ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo Scandinavian Cardiac Outcomes Trial lipid Lowering Arm: (ASCOT-LLA) a multicentre randomised controlled trial. Lancet 2003; 361: 1149–58.PubMedCrossRef Sever PS, Dhalof B, Poulter NR, et al., on behalf of the ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo Scandinavian Cardiac Outcomes Trial lipid Lowering Arm: (ASCOT-LLA) a multicentre randomised controlled trial. Lancet 2003; 361: 1149–58.PubMedCrossRef
4.
go back to reference Schuster H, Barter PJ, Stender S, et al. Effect of switching statin on achievement of lipid goals: Measuring Effective Reduction in Cholesterol using Rosuvastatin Therapy (MERCURY I) study. Am Heart J 2004; 147: 705–12.PubMedCrossRef Schuster H, Barter PJ, Stender S, et al. Effect of switching statin on achievement of lipid goals: Measuring Effective Reduction in Cholesterol using Rosuvastatin Therapy (MERCURY I) study. Am Heart J 2004; 147: 705–12.PubMedCrossRef
5.
go back to reference Olsson AG, Istad H, Luurila O, et al. Effect of rosuvastatin and atorvastatin compared over 52 weeks of treatment in patients with hypercholesterolemia. Am Heart J 2002; 144: 1044–51.PubMedCrossRef Olsson AG, Istad H, Luurila O, et al. Effect of rosuvastatin and atorvastatin compared over 52 weeks of treatment in patients with hypercholesterolemia. Am Heart J 2002; 144: 1044–51.PubMedCrossRef
6.
go back to reference Shepherd J, Hunninghake DB, Stein EA, et al. Safety of rosuvastatin. Am J Cardiol 2004; 94: 882–8.PubMedCrossRef Shepherd J, Hunninghake DB, Stein EA, et al. Safety of rosuvastatin. Am J Cardiol 2004; 94: 882–8.PubMedCrossRef
7.
go back to reference Rodenburg J, Vissers MN, Wiegman A, et al. Statin treatment in children with familial hypercholesterolemia: the younger, the better. Circulation 2007; 116: 664–8.PubMedCrossRef Rodenburg J, Vissers MN, Wiegman A, et al. Statin treatment in children with familial hypercholesterolemia: the younger, the better. Circulation 2007; 116: 664–8.PubMedCrossRef
8.
go back to reference Saltissi D, Westhuyzen J, Morgan C, et al. Efficacy, safety and tolerability of atorvastatin in dyslipidemic subjects with advanced (non-nephrotic) and end-stage chronic renal failure. Clin Exp Nephrol 2006; 10: 201–9.PubMedCrossRef Saltissi D, Westhuyzen J, Morgan C, et al. Efficacy, safety and tolerability of atorvastatin in dyslipidemic subjects with advanced (non-nephrotic) and end-stage chronic renal failure. Clin Exp Nephrol 2006; 10: 201–9.PubMedCrossRef
9.
go back to reference Schwartz GG, Bolognese MA, Tremblay BP, et al. Efficacy and safety of rosuvastatin and atorvastatin in patients with hypercholesterolemia and high risk of coronary heart disease: a randomised, controlled trial. Am Heart J 2004; 148: (1): H1–9.CrossRef Schwartz GG, Bolognese MA, Tremblay BP, et al. Efficacy and safety of rosuvastatin and atorvastatin in patients with hypercholesterolemia and high risk of coronary heart disease: a randomised, controlled trial. Am Heart J 2004; 148: (1): H1–9.CrossRef
10.
go back to reference Olsson AG, McTaggart F, Raza A. Rosuvastatin a highly effective new HMG-CoA reductase inhibitor. Cardiovasc Drug Rev 2002; 20: 303–28.PubMedCrossRef Olsson AG, McTaggart F, Raza A. Rosuvastatin a highly effective new HMG-CoA reductase inhibitor. Cardiovasc Drug Rev 2002; 20: 303–28.PubMedCrossRef
11.
go back to reference McKenney JM. Efficacy and safety of rosuvastatin in treatment of dyslipidemia. Am J Health Syst Pharma 2005; 62: 1033–47. McKenney JM. Efficacy and safety of rosuvastatin in treatment of dyslipidemia. Am J Health Syst Pharma 2005; 62: 1033–47.
12.
go back to reference Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effect of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study. A randomised controlled trial. JAMA 2001; 285: 1711–8.PubMedCrossRef Schwartz GG, Olsson AG, Ezekowitz MD, et al. Effect of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study. A randomised controlled trial. JAMA 2001; 285: 1711–8.PubMedCrossRef
13.
go back to reference Davidson M, Ma P, Stein EA, et al. Comparison of effects on low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with rosuvastatin versus atorvastatin in patients with type IIa or IIb hypercholesterolemia. Am J Cardiol 2002; 89: 268–75.PubMedCrossRef Davidson M, Ma P, Stein EA, et al. Comparison of effects on low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with rosuvastatin versus atorvastatin in patients with type IIa or IIb hypercholesterolemia. Am J Cardiol 2002; 89: 268–75.PubMedCrossRef
14.
go back to reference Cheng JW. Rosuvastatin in the management of hyperlipidemia. Clin Ther 2004; 103: 1368–87.CrossRef Cheng JW. Rosuvastatin in the management of hyperlipidemia. Clin Ther 2004; 103: 1368–87.CrossRef
15.
go back to reference Clearfield M, Amerena J, Bassand J-P, et al. Comparison of the efficacy and safety of rosuvastatin 10mg and atorvastatin 20mg in high-risk patients with hypercholesterolemia. Prospective Study to evaluate the use of low doses of the Statin Atorvastatin and Rosuvastatin (PULSAR). Trials 2006; 7: 35.PubMedCrossRef Clearfield M, Amerena J, Bassand J-P, et al. Comparison of the efficacy and safety of rosuvastatin 10mg and atorvastatin 20mg in high-risk patients with hypercholesterolemia. Prospective Study to evaluate the use of low doses of the Statin Atorvastatin and Rosuvastatin (PULSAR). Trials 2006; 7: 35.PubMedCrossRef
16.
go back to reference Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.PubMed Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.PubMed
17.
go back to reference Cheung RC, Morrell JM, Kallend D, et al. Effects of switching statins on lipid and apolipoprotein ratios in the MERCURY I study. Int J Cardiol 2005 Apr 20; 100: 309–16. Cheung RC, Morrell JM, Kallend D, et al. Effects of switching statins on lipid and apolipoprotein ratios in the MERCURY I study. Int J Cardiol 2005 Apr 20; 100: 309–16.
18.
go back to reference Deedwania PC, Hunninghake DB, Bays HE, et al., for the STELLAR Study Group. Effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin on atherogenic dyslipidemia in patients with characteristics of the metabolic syndrome. Am J Cardiol 2005; 95: 360–6.PubMedCrossRef Deedwania PC, Hunninghake DB, Bays HE, et al., for the STELLAR Study Group. Effects of rosuvastatin, atorvastatin, simvastatin, and pravastatin on atherogenic dyslipidemia in patients with characteristics of the metabolic syndrome. Am J Cardiol 2005; 95: 360–6.PubMedCrossRef
19.
go back to reference Schuster H, Fox JC. Investigating Cardiovascular risk reduction: the rosuvastatin GALAXY Programme. Expert Opin Pharmacother 2004; 5: 1188–200. Schuster H, Fox JC. Investigating Cardiovascular risk reduction: the rosuvastatin GALAXY Programme. Expert Opin Pharmacother 2004; 5: 1188–200.
20.
go back to reference Kapur NK. Rosuvastatin: a highly potent statin for the prevention and managment of coronary artery desease. Expert Rev Cardiovasc Ther 2007; 5: 161–75.PubMedCrossRef Kapur NK. Rosuvastatin: a highly potent statin for the prevention and managment of coronary artery desease. Expert Rev Cardiovasc Ther 2007; 5: 161–75.PubMedCrossRef
21.
go back to reference Hirsch M, O’Donnell J. Rosuvastatin is cost effective compared with atorvastatin in reaching cholesterol goals. Int J Clin Pract 2005; 104: 251–6. Hirsch M, O’Donnell J. Rosuvastatin is cost effective compared with atorvastatin in reaching cholesterol goals. Int J Clin Pract 2005; 104: 251–6.
Metadata
Title
Effects of Low-Dose Atorvastatin and Rosuvastatin on Plasma Lipid Profiles
A Long-Term, Randomized, Open-Label Study in Patients with Primary Hypercholesterolemia
Authors
Dr Fabio Mazza
Claudia Stefanutti
Serafina Di Giacomo
Antonio Vivenzio
Nadia Fraone
Bruno Mazzarella
Antonello Bucci
Publication date
01-07-2008
Publisher
Springer International Publishing
Published in
American Journal of Cardiovascular Drugs / Issue 4/2008
Print ISSN: 1175-3277
Electronic ISSN: 1179-187X
DOI
https://doi.org/10.2165/00129784-200808040-00006

Other articles of this Issue 4/2008

American Journal of Cardiovascular Drugs 4/2008 Go to the issue