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通用型瑞舒伐他汀在实际应用中的疗效与安全性:黎巴嫩患者的前瞻性观察性临床研究

Efficacy and safety of a generic rosuvastatin in a real-world setting: prospective, observational clinical study in Lebanese patients.

作者信息

Betto Mohamad, Fares Jocelyne, Saliba Nada, Ballout Hajar

机构信息

Correspondence: Dr. Mohamad Betto Department of Cardiology,, Makassed General Hospital, Malaab Sector, Beirut 961, Lebanon

出版信息

Ann Saudi Med. 2017 Sep-Oct;37(5):366-374. doi: 10.5144/0256-4947.2017.366.

Abstract

BACKGROUND

No published studies have assessed the efficacy and safety of rosuvastatin generics.

OBJECTIVES

Primary objective to assess the safety and efficacy of a generic rosuvastatin in reducing plasma low-density-lipoprotein cholesterol (LDL-C) in Lebanese dyslipidemic patients. Changes in high-density lipoprotein cholesterol, triglycerides and adverse effects were secondary objectives.

DESIGN

Prospective, observational, non-comparative.

SETTING

Multiple outpatient clinics in Lebanon.

PATIENTS AND METHODS

Dyslipidemic patients requiring statin therapy were followed for 2 months after prescription of a generic rosuvastatin at the physician's discretion. Efficacy and safety measurements were collected from medical records.

MAIN OUTCOME MEASURES

Efficacy was assessed based on the evaluation of mean and percent change in LDL-C between baseline and week 8 as well as the proportion of patients reaching target LDL-C levels. Safety was assessed based on the evaluation of the incidence of adverse events (AEs) during the study period.

RESULTS

Two months after initiation of generic rosuvastatin, LDL-C levels in the 313 eligible patients who completed the study significantly decreased from 4.3 (0.8) mmol/L (168.2 [31.3] mg/dL) at baseline to 2.7 (0.7) mmol/L (105.9 [25.5] mg/dL) (P < .001). The mean percent change in LDL-C level was highest in subjects receiving generic rosuvastatin at a dose of 40 mg/day (-47.4%), followed by 20 mg/day (-36.8%), and 10 mg/ day (-31.4%); 82.5% of patients reached the target LDL-C level as set by their physician at baseline. Thirteen patients (4%) reported six AEs during treatment: abdominal pain, headache, stomach ache, insomnia, musculoskeletal pain/myalgia and nausea. No clinically significant changes in serum creatinine, serum creatine kinase, or liver function tests were reported. One patient withdrew because of an adverse event.

CONCLUSIONS

Generic rosuvastatin was efficacious and safe in reducing LDL-C levels and helping the majority of patients achieve LDL-C targets after a short treatment period.

LIMITATIONS

The observational nature, and a control group, and the relatively short duration of follow-up limit the generalizability of results. The authors received fees for study activities at patient visits from an independent clinical research organization subcontracted by the sponsor.

摘要

背景

尚无已发表的研究评估瑞舒伐他汀仿制药的疗效和安全性。

目的

主要目的是评估一种瑞舒伐他汀仿制药在降低黎巴嫩血脂异常患者血浆低密度脂蛋白胆固醇(LDL-C)方面的安全性和疗效。高密度脂蛋白胆固醇、甘油三酯的变化以及不良反应为次要目的。

设计

前瞻性、观察性、非对照性研究。

地点

黎巴嫩的多家门诊诊所。

患者和方法

需要他汀类药物治疗的血脂异常患者在医生的判断下服用瑞舒伐他汀仿制药后随访2个月。从病历中收集疗效和安全性测量数据。

主要观察指标

疗效根据基线和第8周之间LDL-C的平均变化和百分比变化以及达到目标LDL-C水平的患者比例进行评估。安全性根据研究期间不良事件(AE)的发生率进行评估。

结果

在开始服用瑞舒伐他汀仿制药两个月后,完成研究的313名符合条件的患者的LDL-C水平从基线时的4.3(0.8)mmol/L(168.2[31.3]mg/dL)显著降至2.7(0.7)mmol/L(105.9[25.5]mg/dL)(P<.001)。接受40mg/天剂量瑞舒伐他汀仿制药的受试者LDL-C水平的平均百分比变化最高(-47.4%),其次是20mg/天(-36.8%)和10mg/天(-31.4%);82.5%的患者达到了医生在基线时设定的目标LDL-C水平。13名患者(4%)在治疗期间报告了6起不良事件:腹痛、头痛、胃痛、失眠、肌肉骨骼疼痛/肌痛和恶心。未报告血清肌酐、血清肌酸激酶或肝功能检查有临床显著变化。一名患者因不良事件退出。

结论

瑞舒伐他汀仿制药在降低LDL-C水平方面有效且安全,并有助于大多数患者在短疗程后达到LDL-C目标。

局限性

观察性研究性质、缺乏对照组以及相对较短的随访时间限制了结果的普遍性。作者从主办方分包的一家独立临床研究组织获得了患者就诊时研究活动的费用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe91/6074194/712ee8189c7d/asm-5-366f1.jpg

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