LDL cholesterol levels after switch from atorvastatin to rosuvastatin

Lewis, Sandra; Olufade, Temitope; Anzalone, Deborah; Malangone-Monaco, Elisabetta; Evans, K.; Johnston, Stephen S.

doi:10.1080/03007995.2017.1421147

Cited by 2 publications

(4 citation statements)

References 14 publications

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“…Patients who switched statins without intensification were included in the modified non-PCSK9 inhibitor cohort, because studies have shown substantial LDL-C lowering among statin-treated patients who switched to a different statin at the same intensity. 15,16 Included patients were ≥18 years old, had a pre-index LDL-C level ≥70 mg/dL at the time of prescription for PCSK9 inhibitor therapy or modification of other LLT, and had high-quality linkable data in the IQVIA claims databases ( Figure 1; Supplementary Table S2). Patients in the modified LLT cohort were matched 1:1 to patients in the PCSK9 inhibitor cohort by the LDL test date (within the same calendar quarter; N=12,345 per cohort).…”

Section: Study Design and Patient Populationmentioning

confidence: 99%

<p>Demographic And Clinical Characteristics Of Patients Prescribed Proprotein Convertase Subtilisin/kexin Type 9 Inhibitor Therapy And Patients Whose Current Lipid-Lowering Therapy Was Modified</p>

Baum¹,

Wade²,

Xiang³

et al. 2019

TCRM

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Purpose: Our objective was to describe the demographic and clinical characteristics of real-world patients in the US with elevated low-density lipoprotein cholesterol (LDL-C) whose lipid-lowering therapy (LLT) ─ both proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor and non-PCSK9 inhibitor ─ was actively modified. Methods: This retrospective cohort study used linked laboratory (Prognos), pharmacy (IMS Formulary Impact Analyzer), and medical claims (IQVIA Dx/LRx or PharMetrics Plus) data. PCSK9 inhibitor-prescribed patients with LDL-C ≥70 mg/dL (multiply by 0.02586 for mmol/L) at the time of prescription were matched by LDL-C test date to patients whose non-PCSK9 inhibitor therapy was modified by intensifying statin therapy, switching statins without intensification, or augmenting with ezetimibe (N=12,345 in each cohort). Baseline demographics, use of LLT, LDL-C values, atherosclerotic cardiovascular disease (ASCVD) diagnoses and cardiovascular comorbidities, and occurrence of major adverse cardiovascular events (MACE) were assessed during the 2-year pre-index period. Results: Mean age was 66.2 years in the PCSK9 inhibitor cohort and 64.1 years in the cohort whose LLT regimen was otherwise modified. Respectively, mean baseline LDL-C values were 150 and 121 mg/dL; 60.3% and 39.0% of patients had ASCVD diagnoses, and 9.6% and 5.1% had experienced a recent MACE. Prevalence of ASCVD diagnoses in the PCSK9 inhibitor and modified non-PCSK9 inhibitor cohorts, respectively, was 15.5% vs 9.1% for acute coronary syndrome, 20.7% vs 8.7% for coronary revascularization, and 22.2% vs 5.1% for possible familial hypercholesterolemia. In addition, 19.8% of patients in the PCSK9 inhibitor cohort were receiving both statins and ezetimibe vs 5.0% in the modified LLT cohort. Conclusion: Physicians are prescribing PCSK9 inhibitor therapy to patients with markedly elevated LDL-C levels who also have comorbid risk factors for adverse cardiovascular events. These results may be of interest to payers and policymakers involved in devising access strategies for PCSK9 inhibitors.

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Section: Study Design and Patient Populationmentioning

confidence: 99%

<p>Demographic And Clinical Characteristics Of Patients Prescribed Proprotein Convertase Subtilisin/kexin Type 9 Inhibitor Therapy And Patients Whose Current Lipid-Lowering Therapy Was Modified</p>

Baum¹,

Wade²,

Xiang³

et al. 2019

TCRM

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“…Previous studies that compared different doses of atorvastatin and rosuvastatin in very-high-risk patients showed that rosuvastatin 40 mg reduces LDL-C levels by 4-7% more than atorvastatin 80 mg and was equally well tolerated 13,14 . In contrast, in a retrospective cohort study recently published in Current Medical Research and Opinion by Lewis et al, patients who switched from atorvastatin 80 mg to rosuvastatin 40 mg showed a median 18% reduction in LDL-C levels 15 . Moreover, in patients who switched from atorvastatin 40 mg to rosuvastatin 20 or 40 mg, LDL-C levels decreased by a median of 21 and 26%, respectively 15 .…”

mentioning

confidence: 84%

“…In contrast, in a retrospective cohort study recently published in Current Medical Research and Opinion by Lewis et al, patients who switched from atorvastatin 80 mg to rosuvastatin 40 mg showed a median 18% reduction in LDL-C levels 15 . Moreover, in patients who switched from atorvastatin 40 mg to rosuvastatin 20 or 40 mg, LDL-C levels decreased by a median of 21 and 26%, respectively 15 . Notably, it is well established that doubling the dose of any statin reduces LDL-C levels by approximately 6% 5 .…”

mentioning

confidence: 84%

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

Mantsiou

Τζιόμαλος

2018

Current Medical Research and Opinion

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Several options exist in very-high risk patients who do not achieve low-density lipoprotein cholesterol (LDL-C) targets despite treatment with atorvastatin 80 mg, including switching to rosuvastatin 40 mg, adding ezetimibe or adding a proprotein convertase subtilisin/kexin type 9 inhibitor. Taking into account the safety, LDL-C lowering capacity, effect on cardiovascular events and cost of these available options, switching to rosuvastatin 40 mg appears to represent the most attractive strategy. Nevertheless, more studies are needed to confirm the effects of this strategy on LDL-C levels given the limited available data.

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LDL cholesterol levels after switch from atorvastatin to rosuvastatin

Abstract: 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.

Cited by 2 publications

References 14 publications

<p>Demographic And Clinical Characteristics Of Patients Prescribed Proprotein Convertase Subtilisin/kexin Type 9 Inhibitor Therapy And Patients Whose Current Lipid-Lowering Therapy Was Modified</p>

<p>Demographic And Clinical Characteristics Of Patients Prescribed Proprotein Convertase Subtilisin/kexin Type 9 Inhibitor Therapy And Patients Whose Current Lipid-Lowering Therapy Was Modified</p>

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

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