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Evidence summaries

Lipid-Lowering Efficacy of Rosuvastatin

Rosuvastatin is effective at lowering blood LDL-cholesterol concentrations and does so in a predictable dose-related manner. Level of evidence: "A"

Summary

A Cochrane review [Abstract] 1 included 108 studies (18 placebo-controlled and 90 before-and-after) with a total of 19 596 subjects. Manufacturer-recommended rosuvastatin doses of 10 to 40 mg/day caused LDL-cholesterol decreases of 46% to 55% (table T1).

LDL-cholesterol lowering efficacy of rosuvastatin

InterventionParticipants (studies)Percent change from baseline (95% CI)
Rosuvastatin 2.5 mg/day450 (11)-39.1% (-40.6 to -37.6%)
Rosuvastatin 5 mg/day2 602 (25)-41.3% (-42.0 to -40.7%)
Rosuvastatin 10 mg/day9 855 (74)-45.6% (-46.0 to -45.3%)
Rosuvastatin 20 mg/day3 675 (28)-49.9% (-50.4 to -49.4%)
Rosuvastatin 40 mg/day3 512 (18)-54.9% (-55.4 to -54.4%)

Log dose-response data over doses of 1 to 80 mg, revealed strong linear dose-related effects on blood total cholesterol, LDL-cholesterol and non-HDL-cholesterol. When compared to atorvastatin, rosuvastatin was about three-fold more potent at reducing LDL-cholesterol. There was no dose-related effect of rosuvastatin on blood HDL-cholesterol, but overall, rosuvastatin increased HDL by 7%.

Withdrawals due to adverse effects were not statistically different between rosuvastatin and placebo in 10 of 18 of these short-term trials. However, this review did not provide a good estimate of the incidence of harms associated with rosuvastatin because of the short duration of the trials and the lack of reporting of adverse effects in 44% of the placebo-controlled trials.

Clinical comments

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    References

    • Adams SP, Sekhon SS, Wright JM. Lipid-lowering efficacy of rosuvastatin. Cochrane Database Syst Rev 2014;(11):CD010254. [PubMed]

Primary/Secondary Keywords