Brown W Virgil, Bays Harold E, Hassman David R, McKenney James, Chitra Rohini, Hutchinson Howard, Miller Elinor
Emory University School of Medicine, Atlanta, Ga 30322, USA.
Am Heart J. 2002 Dec;144(6):1036-43. doi: 10.1067/mhj.2002.129312.
The primary objective of this trial was to compare the efficacy of rosuvastatin with that of pravastatin and simvastatin for lowering low-density lipoprotein cholesterol (LDL-C) levels.
In this randomized, double-blind, multicenter trial, lipid levels were measured in 477 patients (baseline LDL-C > or =160 and <250 mg/dL) who received fixed doses of 5 mg of rosuvastatin, 10 mg of rosuvastatin, 20 mg of pravastatin, or 20 mg of simvastatin for 12 weeks. For an additional 40 weeks, individual daily doses were sequentially doubled to a maximum of 80 mg of rosuvastatin, 40 mg of pravastatin, and 80 mg of simvastatin, according to investigator discretion and if National Cholesterol Education Program Adult Treatment Panel II (ATP II) LDL-C goals were not achieved.
At 12 weeks, percent LDL-C reductions after both 5-mg and 10-mg rosuvastatin treatment, which were 39.1% and 47.4%, respectively, were significantly different (P <.05) from LDL-C reductions after 20-mg pravastatin (26.5%) and 20-mg simvastatin (34.6%) treatment. After 52 weeks, more rosuvastatin-treated patients remained at their starting dose than did simvastatin or pravastatin patients. After dose titration, 88% and 87.5% of the rosuvastatin 5-mg and 10-mg groups, respectively, achieved their ATP II LDL-C goals, compared with 60% for pravastatin and 72.5% for simvastatin. All study treatments were well tolerated.
Rosuvastatin reduced LDL-C levels more than pravastatin or simvastatin in patients with hypercholesterolemia in a 52-week dose-titration study.
本试验的主要目的是比较瑞舒伐他汀与普伐他汀和辛伐他汀降低低密度脂蛋白胆固醇(LDL-C)水平的疗效。
在这项随机、双盲、多中心试验中,对477例患者(基线LDL-C≥160且<250mg/dL)进行血脂水平测量,这些患者接受固定剂量的5mg瑞舒伐他汀、10mg瑞舒伐他汀、20mg普伐他汀或20mg辛伐他汀治疗12周。在接下来的40周内,根据研究者的判断,并且如果未达到美国国家胆固醇教育计划成人治疗小组II(ATP II)的LDL-C目标,个体每日剂量依次加倍,瑞舒伐他汀最高达80mg,普伐他汀最高达40mg,辛伐他汀最高达80mg。
在12周时,5mg和10mg瑞舒伐他汀治疗后LDL-C降低百分比分别为39.1%和47.4%,与20mg普伐他汀(26.5%)和20mg辛伐他汀(34.6%)治疗后的LDL-C降低百分比相比有显著差异(P<.05)。52周后,与辛伐他汀或普伐他汀治疗的患者相比,更多接受瑞舒伐他汀治疗的患者维持在起始剂量。剂量滴定后,瑞舒伐他汀5mg组和10mg组分别有88%和87.5%的患者达到ATP II的LDL-C目标,相比之下,普伐他汀组为60%,辛伐他汀组为72.5%。所有研究治疗的耐受性均良好。
在一项为期52周的剂量滴定研究中,对于高胆固醇血症患者,瑞舒伐他汀降低LDL-C水平的效果优于普伐他汀或辛伐他汀。