Comparison of low-density lipoprotein cholesterol reduction after switching patients on other statins to rosuvastatin or simvastatin in a real-world clinical practice setting

Am J Manag Care. 2007 Dec;13 Suppl 10:S270-5.

Abstract

Objective: The study compared low-density lipoprotein cholesterol (LDL-C) reduction obtained after switching patients on a statin therapy to rosuvastatin or simvastatin in real-world clinical practice.

Methods: Using information from an electronic medical records database, for patients >or=18 years of age who received newly prescribed statin therapy during August 2003 to March 2006, who were switched to either rosuvastatin or simvastatin, and who had LDL-C values at baseline, switch and postswitch data were included (N = 277). Percent LDL-C reduction between patients switched to rosuvastatin (n = 155) and those switched to simvastatin (n = 122) were compared. Linear regression model was adjusted for percent LDL-C change from preswitch to switch, LDL-C at time of switch, age, sex, smoking, statin aggressiveness, and therapy duration postswitch. Percent LDL-C reduction for patients switched from atorvastatin to rosuvastatin versus atorvastatin to simvastatin was also compared.

Results: Patients switched to rosuvastatin or simvastatin were similar in age, sex, and baseline LDL-C (mean, 146 mg/dL). Patients switched to rosuvastatin from any other statin had a significantly greater percent LDL-C reduction (18.4%) postswitch than patients switched to simvastatin (5.8%; P = .0003). After adjusting for baseline covariates, rosuvastatin patients had a significantly greater percent LDL-C reduction postswitch than simvastatin patients (16.0% vs 8.8%, respectively; P = .0002). In the subgroup of patients switched from atorvastatin, patients switched to rosuvastatin (n = 67) had a significantly greater adjusted percent LDL-C reduction (13.6%) postswitch than patients switched to simvastatin (5.5%; n = 75; P = .001).

Conclusion: Rosuvastatin achieves greater percent LDL-C reduction than simvastatin as a switch therapy in a real-world clinical practice setting. This highlights the need to select the statin to switch to based on additional needed percent LDL-C reduction to meet individual patient targets. Availability of simvastatin (generic statin) and rosuvastatin (branded statin) as treatment options would facilitate efficient and effective management of patients with dyslipidemia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Atorvastatin
  • Cholesterol, LDL / blood*
  • Female
  • Fluorobenzenes / therapeutic use*
  • Heptanoic Acids / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / drug therapy*
  • Male
  • Medical Records Systems, Computerized
  • Pyrimidines / therapeutic use*
  • Pyrroles / therapeutic use*
  • Retrospective Studies
  • Rosuvastatin Calcium
  • Simvastatin / therapeutic use*
  • Sulfonamides / therapeutic use*
  • Treatment Outcome

Substances

  • Cholesterol, LDL
  • Fluorobenzenes
  • Heptanoic Acids
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Pyrroles
  • Sulfonamides
  • Rosuvastatin Calcium
  • Atorvastatin
  • Simvastatin