Rosuvastatin (Crestor;
AstraZeneca) is more effective than atorvastatin (Lipitor; Pfizer, Inc.)
All across dose ranges in
reducing low-density lipoprotein (LDL) cholesterol and improving lipid profiles,
rosuvastatin was more effective in patients with hypercholesterolemia. That,
according to a report in the January 1st issue of the American Journal of
Cardiology.
However, significantly lower
triglyceride levels were achieved with atorvastatin 80 mg compared with
rosuvastatin.
This study represents the "first prospective
investigation to directly compare the lipid-altering effects of these two
statins at fixed levels across the entire range of dosages for each drug in
patients with hypercholesterolemia and without active arterial disease," Dr.
Dennis W. Schneck, of AstraZeneca, Wilmington, Delaware, and colleagues write.
In this 6-week, randomized, double-blind study,
the patients had baseline LDL cholesterol of at least 160 mg/dL but less than
250 mg/dL and fasting triglycerides less than 400 mg/dL. Two hundred nine
patients received once-daily rosuvastatin (5, 10, 20, 40, or 80 mg) and 165
patients received once-daily atorvastatin (10, 20, 40, or 80 mg).
Rosuvastatin produced greater dose-dependent
decreases in LDL cholesterol (ranging from -46.6% at 10 mg to -61.9% at 80 mg)
than did atorvastatin (-38.2% at 10 mg to -53.5% at 80 mg). Compared with
atorvastatin, rosuvastatin produced a mean 8.4% greater decrease from baseline
in LDL cholesterol (p < 0.001).
Rosuvastatin also produced greater mean decreases
in total cholesterol (4.9%, p < 0.001), non-HDL cholesterol (7.0%, p < 0.001),
and apolipoprotein B (6.3%, p < 0.001) across dosage ranges. Compared with
atorvastatin, rosuvastatin produced significant decreases in all lipoprotein
ratios (p < 0.001).
"Because dose responses for HDL cholesterol,
triglycerides, and apolipoprotein A-1 were non-log-linear and nonparallel
between the two drugs, percentage changes from baseline were compared at each
dose," Dr. Schneck and colleagues explain.
The team notes that 80 mg atorvastatin produced
significantly greater decreases in triglycerides compared with 80 mg
rosuvastatin.
Both drugs were well tolerated over 6 weeks. "Clinically relevant increases in hepatic transaminases or creatine kinase, indicative of hepatotoxicity or myotoxicity, were not observed with either trial medication," they add.
Source: Diabetes In Control Dot Com: American Journal of Cardiology 2003;91:33-41.
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