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瑞舒伐他汀与阿托伐他汀在中国高危高胆固醇血症患者中的疗效和安全性:一项随机、双盲、活性药物对照研究。

Efficacy and safety of rosuvastatin versus atorvastatin in high-risk Chinese patients with hypercholesterolemia: a randomized, double-blind, active-controlled study.

作者信息

Zhao Shuiping, Peng Daoquan

机构信息

a Department of Cardiology , Second Xiangya Hospital, Central South University , Changsha , Hunan , China.

出版信息

Curr Med Res Opin. 2018 Feb;34(2):227-235. doi: 10.1080/03007995.2017.1371584. Epub 2017 Sep 18.

DOI:10.1080/03007995.2017.1371584
PMID:28836458
Abstract

OBJECTIVE

To evaluate and compare the efficacy and safety of rosuvastatin versus atorvastatin in a high-risk Chinese population with hypercholesterolemia.

RESEARCH DESIGN AND METHODS

This 6 week, prospective, multicenter, double-blind, three-arm, parallel-group, active-controlled study randomized adult Chinese patients (low-density lipoprotein cholesterol [LDL-C] ≥ 130-<250 mg/dL statin-naive and ≥100-<160 mg/dL in statin treated) to receive rosuvastatin (5 mg or 10 mg) or atorvastatin 10 mg. Patients not achieving National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III LDL-C targets in the randomized phase were administered rosuvastatin 10 mg and 20 mg in the open-label phase.

RESULTS

In total 414 patients (mean age: 59.5 ± 9.51 years, 59.4% females, mean LDL-C: 4.242 ± 0.676 mmol/L (rosuvastatin 5 mg), 4.13 ± 0.682 mmol/L (rosuvastatin 10 mg) and 4.213 ± 0.662 mmol/L (atorvastatin 10 mg) were analyzed. Compared with atorvastatin 10 mg, rosuvastatin 5 mg (-41.70% vs. -38.67%, p = .132) and rosuvastatin 10 mg showed greater LDL-C reduction (-46.28% vs. -38.67%, p = .0002). LDL-C target achievement rates with rosuvastatin 5 mg, rosuvastatin 10 mg and atorvastatin 10 mg were 61.0%, 79.1% and 58.3% in the randomized phase. In the open-label phase, LDL-C target achievement occurred in >40% with both doses of rosuvastatin. The rate of ≥1 adverse event was similar with rosuvastatin 5 mg (12.4%), 10 mg (11.7%) and atorvastatin 10 mg (8.9%).

CONCLUSION

Rosuvastatin 5 mg demonstrated non-inferiority and rosuvastatin 10 mg demonstrated superiority to atorvastatin 10 mg for lowering LDL-C in high-risk Chinese patients with dyslipidemia, which was maintained through the open-label phase.

CLINICAL TRIAL REGISTRATION

NCT00683618.

摘要

目的

评估并比较瑞舒伐他汀与阿托伐他汀在高危中国高胆固醇血症患者中的疗效和安全性。

研究设计与方法

这项为期6周的前瞻性、多中心、双盲、三臂、平行组、活性药物对照研究,将成年中国患者(低密度脂蛋白胆固醇[LDL-C]≥130 - <250mg/dL未服用他汀类药物者及≥100 - <160mg/dL服用他汀类药物者)随机分组,分别接受瑞舒伐他汀(5mg或10mg)或阿托伐他汀10mg治疗。在随机化阶段未达到美国国家胆固醇教育计划(NCEP)成人治疗小组(ATP)III LDL-C目标的患者,在开放标签阶段给予瑞舒伐他汀10mg和20mg治疗。

结果

共分析了414例患者(平均年龄:59.5±9.51岁,女性占59.4%,平均LDL-C:瑞舒伐他汀5mg组为4.242±0.676mmol/L,瑞舒伐他汀10mg组为4.13±0.682mmol/L,阿托伐他汀10mg组为4.213±0.662mmol/L)。与阿托伐他汀10mg相比,瑞舒伐他汀5mg(-41.70%对-38.67%,p = 0.132)和瑞舒伐他汀10mg降低LDL-C的幅度更大(-46.28%对-38.67%,p = 0.0002)。在随机化阶段,瑞舒伐他汀5mg、瑞舒伐他汀10mg和阿托伐他汀10mg达到LDL-C目标的比率分别为61.0%、79.1%和58.3%。在开放标签阶段,两种剂量的瑞舒伐他汀达到LDL-C目标的比例均超过40%。≥1次不良事件的发生率在瑞舒伐他汀5mg组(12.4%)、10mg组(11.7%)和阿托伐他汀10mg组(8.9%)相似。

结论

对于高危中国血脂异常患者,瑞舒伐他汀5mg显示出非劣效性,瑞舒伐他汀10mg在降低LDL-C方面优于阿托伐他汀10mg,且在开放标签阶段仍保持这一优势。

临床试验注册号

NCT00683618。

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