Comparison of different cholesterol lowering for statins

• the STELLAR (Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin) study, compared rosuvastatin, atorvastatin, simvastatin and pravastatin across licensed doses for reducing LDL cholesterol and other lipid parameters in patients (n=2,431) with hypercholesterolaemia (LDL-C > 160 and < 250 mg/dL [> 4.14 and < 6.47 mmol/L respectively]; triglycerides < 400 mg/dL [< 4.52 mmol/L])
  • found that after six weeks of treatment, rosuvastatin resulted in significantly greater LDL-C reductions dose for dose compared with other statins
    • analyses showed that rosuvastatin 10 to 80 mg * reduced LDL cholesterol by a mean of 8.2% more than atorvastatin 10 to 80 mg, 26% more than pravastatin 10 to 40 mg, and 12% to 18% more than simvastatin 10 to 80 mg (all p <0.001)
      
      
      • rosuvastatin 10mg led to an average 46% LDL reduction
        
        
      • atorvastatin 10mg led to an average 37% LDL reduction
        
        
      • simvastatin 40mg led to an average 39% LDL reduction
        
        
      • pravastatin 40mg led to an average 30% LDL reduction
        
        
      • mean percent changes in high-density lipoprotein cholesterol in the rosuvastatin groups were +7.7% to +9.6% compared with +2.1% to +6.8% in all other groups
      • across dose ranges, rosuvastatin reduced total cholesterol significantly more (p <0.001) than all comparators and triglycerides significantly more (p <0.001) than simvastatin and pravastatin
      • Adult Treatment Panel III LDL cholesterol goals were achieved by 82% to 89% of patients treated with rosuvastatin 10 to 40 mg compared with 69% to 85% of patients treated with atorvastatin 10 to 80 mg
      • drug tolerability was similar across treatments

*a maximum dose of 80mg of rosuvastatin was used in this trial

Reference:

1. Jones PH, Davidson MH, Stein EA et al. for the STELLAR study group. Comparison of the Efficacy and Safety of Rosuvastatin Versus Atorvastatin, Simvastatin and Pravastatin Across Doses (STELLAR Trial). Am J Cardiol 2003;92:152-60.