AstraZeneca Gothenburg, Pepparedsleden 1, Mölndal SE-431 83, Sweden Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-413 45, Sweden
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-413 45, Sweden.
Eur Heart J Cardiovasc Pharmacother. 2016 Oct;2(4):212-7. doi: 10.1093/ehjcvp/pvw006. Epub 2016 Mar 29.
AIMS: Patient response to statin treatment is individual and varied. As a consequence, when using a specific-dose approach, as recommended in the 2013 American College of Cardiology/American Heart Association guideline, there will be a range of reductions in the concentration of low-density lipoprotein cholesterol (LDL-C). The aim of this study was to use individual patient data from the VOYAGER meta-analysis to determine the extent of the variability in LDL-C reduction in response to treatment across the recommended doses of different statins. METHODS AND RESULTS: The percentage change from baseline in LDL-C was calculated using individual subject data collected from 32 258 patients treated with atorvastatin 10-80 mg, rosuvastatin 5-40 mg, or simvastatin 10-80 mg. The percentage change in LDL-C for each patient was then used to generate waterfall plots that demonstrated the extent of the variability in response to treatment at all doses of the three statins. The standard deviation of LDL-C reduction for all statins and doses ranged from 12.8 to 17.9%. The percentage of patients experiencing a suboptimal response (<30% reduction in LDL-C) ranged from 5.3 to 53.3%. CONCLUSION: These results indicate that there is considerable individual variation in the LDL-C reduction at all doses of simvastatin, atorvastatin, and rosuvastatin.
目的:患者对他汀类药物治疗的反应是个体差异的。因此,当使用特定剂量方法时,如 2013 年美国心脏病学会/美国心脏协会指南所推荐的那样,低密度脂蛋白胆固醇(LDL-C)的浓度会有一系列降低。本研究的目的是利用 VOYAGER 荟萃分析的个体患者数据,确定在推荐剂量范围内,不同他汀类药物治疗的 LDL-C 降低的变异性程度。
方法和结果:使用阿托伐他汀 10-80mg、瑞舒伐他汀 5-40mg 或辛伐他汀 10-80mg 治疗的 32258 例患者的个体受试者数据计算 LDL-C 从基线的百分比变化。然后,使用每个患者的 LDL-C 百分比变化生成瀑布图,以显示三种他汀类药物在所有剂量下治疗反应的变异性程度。所有他汀类药物和剂量的 LDL-C 降低的标准差范围为 12.8%至 17.9%。经历非最佳反应(LDL-C 降低<30%)的患者比例范围为 5.3%至 53.3%。
结论:这些结果表明,辛伐他汀、阿托伐他汀和瑞舒伐他汀在所有剂量下的 LDL-C 降低都存在相当大的个体差异。
Eur Heart J Cardiovasc Pharmacother. 2016-3-29
J Womens Health (Larchmt). 2016-1