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瑞舒伐他汀5毫克疗效综述。

Review of efficacy of rosuvastatin 5 mg.

作者信息

Teramoto T, Watkins C

机构信息

Teikyo University School of Medicine,Tokyo, Japan.

出版信息

Int J Clin Pract. 2005 Jan;59(1):92-101. doi: 10.1111/j.1742-1241.2005.00346.x.

Abstract

The prevalence of coronary heart disease (CHD) has been increasing in the past few decades in Japan, as it has in industrialised countries worldwide. CHD risk can be substantially reduced by lowering low-density lipoprotein cholesterol (LDL-C) in patients with dyslipidaemia. Statins are highly effective for this indication, but many patients treated with these drugs still do not meet their treatment goals, often because clinicians fail to titrate these patients to a higher, potentially more effective, dose. Thus, there is a need for more effective agents that can help patients reach their goals at starting doses. This paper reviews key clinical results for a new agent, rosuvastatin. The data show that rosuvastatin 5 mg is highly effective in lowering LDL-C to recommended levels for most patients (mean reductions ranging from 42 to 52%). In addition, rosuvastatin 5 mg effectively lowers triglycerides (-16%), total cholesterol (-30%), non-high-density lipoprotein cholesterol (non-HDL-C; -38%) and apolipoprotein (apo) B levels (-33%) and increases HDL-C (+8.2-13%) in a wide range of patients with hypercholesterolaemia, including the elderly, obese patients, postmenopausal women and patients with hypertension, CHD, diabetes and metabolic syndrome. The 5-mg dose of rosuvastatin dose also produces greater reductions in LDL-C and larger increases in HDL-C than recommended initial doses of atorvastatin, simvastatin or pravastatin (for LDL-C reductions, p <0.001 vs. atorvastatin 10 mg, simvastatin 20 mg and pravastatin 20 mg; for HDL-C elevations, p <0.01 vs. atorvastatin 10 mg). These results demonstrate that rosuvastatin 5 mg produces favourable effects on the lipid profile and helps more patients achieve LDL-C goals than comparator statins.

摘要

在过去几十年里,日本冠心病(CHD)的患病率一直在上升,全球工业化国家的情况也是如此。通过降低血脂异常患者的低密度脂蛋白胆固醇(LDL-C),可以大幅降低冠心病风险。他汀类药物对此适应症非常有效,但许多接受这些药物治疗的患者仍未达到治疗目标,这通常是因为临床医生未能将这些患者的药物剂量滴定至更高的、可能更有效的剂量。因此,需要更有效的药物,以便患者在起始剂量时就能达到治疗目标。本文综述了一种新药瑞舒伐他汀的关键临床结果。数据显示,5毫克瑞舒伐他汀对大多数患者而言,能非常有效地将LDL-C降至推荐水平(平均降低幅度为42%至52%)。此外,5毫克瑞舒伐他汀能有效降低甘油三酯(-16%)、总胆固醇(-30%)、非高密度脂蛋白胆固醇(非HDL-C;-38%)和载脂蛋白(apo)B水平(-33%),并能提高广泛的高胆固醇血症患者(包括老年人、肥胖患者、绝经后女性以及患有高血压、冠心病、糖尿病和代谢综合征的患者)的高密度脂蛋白胆固醇(HDL-C;+8.2 - 13%)。与阿托伐他汀、辛伐他汀或普伐他汀的推荐初始剂量相比,5毫克剂量的瑞舒伐他汀在降低LDL-C方面效果更显著,提高HDL-C的幅度更大(对于LDL-C降低幅度,与10毫克阿托伐他汀、20毫克辛伐他汀和20毫克普伐他汀相比,p <0.001;对于HDL-C升高幅度,与10毫克阿托伐他汀相比,p <0.01)。这些结果表明,与对照他汀类药物相比,5毫克瑞舒伐他汀对血脂谱有良好影响,能帮助更多患者实现LDL-C目标。

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