Impact of the JUPITER trial on statin prescribing for primary prevention

Pharmacotherapy. 2014 Jan;34(1):9-18. doi: 10.1002/phar.1340. Epub 2013 Aug 12.


Study objective: As the Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER) trial identified a new population of individuals with cholesterol levels below traditional treatment thresholds but with elevated high-sensitivity C-reactive protein (hs-CRP) levels who may benefit from primary prevention with statin therapy, we sought to evaluate the impact of this trial on the incident prescription rates of rosuvastatin alone as well as all statins in a primary prevention population.

Design: Population-based, cross-sectional time-series analysis.

Data source: Administrative health care databases in Ontario, Canada.

Patients: A total of 299,809 incident statin users 66 years or older were identified during the study period, from January 1, 2003, to March 31, 2011, who were prescribed statin therapy for primary prevention.

Measurements and main results: We evaluated the incident rate of rosuvastatin and all statin use during each quarter of the study period. Overall, no significant trends in all incident statin use were observed (p=0.99). Furthermore, no significant differences were observed in incident rates of rosuvastatin (p=0.21) or all statin (p=0.41) use after the publication of the JUPITER trial. Despite the lack of impact of the JUPITER trial on rosuvastatin or all statin utilization, the relative market share of rosuvastatin increased from 9% to 65% over the study period.

Conclusion: The publication of the JUPITER trial did not significantly affect trends in overall statin and rosuvastatin prescribing patterns for primary prevention in this study. Increases in the relative market share of rosuvastatin may be attributed to the impact of the pharmaceutical industry on prescribing patterns. Our results highlight the need to further improve the integration of evidence-based prescribing into cost-effective clinical practice.

Keywords: JUPITER trial; drug utilization; primary prevention; rosuvastatin; statins.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Cohort Studies
  • Cross-Sectional Studies
  • Drug Prescriptions*
  • Female
  • Fluorobenzenes / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypercholesterolemia / epidemiology
  • Hypercholesterolemia / prevention & control
  • Male
  • Ontario / epidemiology
  • Population Surveillance / methods
  • Primary Prevention / methods
  • Primary Prevention / trends*
  • Pyrimidines / therapeutic use*
  • Rosuvastatin Calcium
  • Sulfonamides / therapeutic use*
  • Treatment Outcome


  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium