Effectiveness of rosuvastatin in reducing LDL-C and target LDL-C goal attainment in real-world clinical practice.

OBJECTIVE: This article reviewed the collective evidence from routine clinical practice to summarize the existing literature on the effectiveness of rosuvastatin in treating hypercholesterolemia.

METHODS: A comprehensive Medline literature search identified all published articles, in all languages, from January 2003 through September 2008 on the use of rosuvastatin in the usual-care setting. The search identified 60 articles, and 16 articles were included in this review because they were observational and non-interventional and included sufficient data specific to rosuvastatin. Excluded articles were clinical trials, cost-effectiveness models, safety, reviews, pharmacokinetics, abstracts or editorials only, or all statins combined. Included rosuvastatin articles were categorized as (1) effectiveness in general population and (2) effectiveness in special populations (e.g., elderly, diabetes).

RESULTS: Seven studies consistently showed that diverse patients from different geographic regions who were newly initiated on rosuvastatin had significantly greater reduction in low-density lipoprotein cholesterol (LDL-C) (29-52%) compared with patients treated with other statins (16-43%). LDL-C goal attainment as recommended by National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III or European Society of Cardiology (ESC) guidelines was consistently and significantly higher among patients treated with rosuvastatin (64-81%) compared with patients treated with other statins (34-73%). Rosuvastatin-treated patients with diabetes or HIV or who were elderly had significantly greater LDL-C reduction and LDL-C goal attainment compared with patients treated with other statins.

LIMITATIONS: Channeling bias or confounding by indication may have influenced the results of the real-world studies, if physicians reserve rosuvastatin for sicker or more difficult to treat patients.

CONCLUSIONS: There is a strong and consistent body of evidence demonstrating the effectiveness of rosuvastatin in lowering LDL-C and LDL-C goal attainment in real life compared with other statins at commonly prescribed doses, which reflects the existing evidence from clinical trials.