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瑞舒伐他汀10至40毫克的获益-风险评估。

Benefit-risk assessment of Rosuvastatin 10 to 40 milligrams.

作者信息

Brewer H Bryan

机构信息

Molecular Disease Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland 20894, USA.

出版信息

Am J Cardiol. 2003 Aug 21;92(4B):23K-29K. doi: 10.1016/s0002-9149(03)00779-3.

Abstract

The aim of this article is to examine the benefit-risk profile of rosuvastatin at doses of 10 to 40 mg. In dyslipidemic patients, rosuvastatin produced markedly greater reductions in low-density lipoprotein (LDL) cholesterol and equivalent or greater improvements in various lipid measures, including high-density lipoprotein (HDL) cholesterol, non-HDL cholesterol, and triglycerides when compared with atorvastatin, simvastatin, and pravastatin. In addition, rosuvastatin is more effective than these statins in allowing patients to reach National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III and Joint European Societies LDL cholesterol goals. The safety profile of rosuvastatin was reviewed (as of April 2003) in 12,569 patients, representing 14,231 patient-years of treatment at doses up to 80 mg. In controlled trials, rosuvastatin 10 to 40 mg demonstrated a similar adverse event profile to those for atorvastatin 10 to 80 mg, simvastatin 10 to 80 mg, and pravastatin 10 to 40 mg. Myopathy (defined as muscle symptoms plus serum creatine kinase levels >10 times the upper limit of normal) attributed to rosuvastatin occurred in < or = 0.03% of patients receiving rosuvastatin 10 to 40 mg. No cases of rhabdomyolysis occurred in patients receiving rosuvastatin 10 to 40 mg. Clinically significant alanine aminotransferase elevations occurred in 0.2% of patients receiving rosuvastatin and those receiving atorvastatin, simvastatin, and pravastatin. Compared with other widely used statins, the benefit-risk profile of rosuvastatin 10 to 40 mg appears to be very favorable.

摘要

本文旨在研究10至40毫克剂量瑞舒伐他汀的获益-风险情况。在血脂异常患者中,与阿托伐他汀、辛伐他汀和普伐他汀相比,瑞舒伐他汀能更显著地降低低密度脂蛋白(LDL)胆固醇水平,在包括高密度脂蛋白(HDL)胆固醇、非HDL胆固醇和甘油三酯等各项血脂指标上有同等程度或更大程度的改善。此外,在使患者达到美国国家胆固醇教育计划(NCEP)成人治疗小组(ATP)III以及欧洲心脏病学会设定的LDL胆固醇目标方面,瑞舒伐他汀比这些他汀类药物更有效。截至2003年4月,对12569例患者(相当于14231患者年,服用剂量最高达80毫克)的瑞舒伐他汀安全性进行了评估。在对照试验中,10至40毫克的瑞舒伐他汀与10至80毫克的阿托伐他汀、10至80毫克的辛伐他汀以及10至40毫克的普伐他汀相比,不良事件情况相似。服用10至40毫克瑞舒伐他汀的患者中,因瑞舒伐他汀导致的肌病(定义为肌肉症状加血清肌酸激酶水平高于正常上限10倍)发生率≤0.03%。服用10至40毫克瑞舒伐他汀的患者未发生横纹肌溶解病例。接受瑞舒伐他汀以及接受阿托伐他汀、辛伐他汀和普伐他汀治疗的患者中,临床显著的丙氨酸氨基转移酶升高发生率均为0.2%。与其他广泛使用的他汀类药物相比,10至40毫克瑞舒伐他汀的获益-风险情况似乎非常有利。

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