Background Rosuvastatin (Crestor), a new, highly efficacious statin,
has demonstrated dose-dependent low-density lipoprotein cholesterol (LDL-C)
reductions of up to 65% in a dose-ranging programme with doses of 1
to 80 mg.
Design A randomized, double-blind multicentre trial compared
rosuvastatin with commonly used starting doses of pravastatin and simvastatin to
determine relative efficacy in LDL-C reduction and impact on other lipid
parameters in primary hypercholesterolaemia.
Methods and results A total of 502 patients (≥ 18 years;
LDL-C ≥ 4.14 mmol/l [160mg/dl] and <6.50mmol/l [250mg/dl]
and triglycerides <4.52 mmol/l [400mg/dl]) were randomized to 12
weeks of rosuvastatin 5 mg (n=120) or 10mg
(n=115), pravastatin 20 mg
(n=137) or simvastatin 20 mg
(n=130). Rosuvastatin 5 and 10mg reduced LDL-C by 42
and 49%, respectively, compared with 28% for pravastatin
(P< 0.001 versus both rosuvastatin doses) and
37% for simvastatin (P<0.01 versus
rosuvastatin 5mg; P < 0.001 versus 10mg). National
Cholesterol Education Program Adult Treatment Panel II (NCEP ATP II) goals were
achieved by 87% of rosuvastatin 10mg patients, 71% of
rosuvastatin 5 mg patients, 53% of pravastatin patients, and
64% of simvastatin patients; similar proportions of patients achieved
NCEP ATP III goals. European Atherosclerosis Society (EAS) goals were achieved
by 83, 63, 20 and 50% of patients, respectively. All study treatments
were well tolerated.
Conclusions Both doses of rosuvastatin were more effective than
pravastatin and simvastatin in meeting NCEP ATP II and EAS LDL-C targets.
Rosuvastatin 10mg was more effective than pravastatin and simvastatin in meeting
NCEP ATP III targets.
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