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Titration patterns with rosuvastatin as compared with other statins in clinical practice: a retrospective

Kathleen M Fox1, Sanjay K Gandhi, Robert L Ohsfeldt

  • 1Department of Epidemiology & Preventive Medicine, School of Medicine, University of Maryland, Baltimore, MD, USA. kathyfox@comcast.net

Clinical Therapeutics
|December 26, 2007
PubMed

Insights

Rosuvastatin patients achieving cholesterol goals required less dose adjustment compared to those on other statins. This suggests a potentially more efficient lipid-lowering effect with rosuvastatin in routine practice.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Clinical Practice

Background:

  • Suboptimal lipid management is common, with many patients not reaching cholesterol targets.
  • Limited upward dose titration of statins may contribute to low goal attainment.

Purpose of the Study:

  • To compare the rate of dose titration in patients achieving low-density lipoprotein cholesterol (LDL-C) goals on rosuvastatin versus other statins in routine clinical practice.
  • To investigate if rosuvastatin use is associated with lower titration rates among patients meeting National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) LDL-C goals.

Main Methods:

  • Retrospective analysis of a US database of patients (aged ≥18) newly prescribed statins between August 2003 and May 2005.
  • Comparison of upward titration rates between rosuvastatin and other statins (atorvastatin, simvastatin, pravastatin, lovastatin) in patients achieving NCEP ATP III LDL-C goals.
  • Multivariate logistic regression adjusted for baseline LDL-C, coronary heart disease risk, treatment duration, and goal attainment.

Main Results:

  • Of 5955 eligible patients, 72.8% attained their LDL-C goal.
  • Patients achieving LDL-C goals on rosuvastatin (8.3%) showed significantly lower titration rates compared to those on atorvastatin (17.0%), simvastatin (20.0%), pravastatin (20.7%), and lovastatin (23.5%).
  • Adjusted analysis confirmed that patients on other statins were more likely to be titrated than rosuvastatin users (ORs 2.0-3.3).

Conclusions:

  • Rosuvastatin users who achieved NCEP ATP III LDL-C goals demonstrated significantly lower dose titration rates compared to users of other statins.
  • This finding suggests a potentially more efficient titration profile for rosuvastatin in achieving and maintaining LDL-C goals in clinical practice.
Abstract

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