College of Pharmacy, QU Health, Qatar University, Doha, 2713, Qatar.
Drug Information Department, Hamad Medical Corporation, Doha, 3050, Qatar.
J Comp Eff Res. 2023 Mar;12(3):e220163. doi: 10.57264/cer-2022-0163. Epub 2023 Feb 27.
To summarize the evidence in terms of efficacy and safety of head-to-head studies of high-intensity statins regardless of the underlying population. A systematic review and meta-analysis was conducted to summarize the effect sizes in randomized controlled trials and cohort studies that compared high-intensity statins. Based on 44 articles, similar effectiveness was observed across the statins in reducing LDL levels from baseline. All statins were observed to have similar adverse drug reactions (ADRs), although higher dosages were associated with more ADRs. Based on a pooled quantitative analysis of atorvastatin 80 mg versus rosuvastatin 40 mg, rosuvastatin was statistically more effective in reducing LDL. This review further confirms that high-intensity statins reduce LDL by ≥50%, favoring rosuvastatin over atorvastatin. Additional data are needed to confirm the clinical significance on cardiovascular outcomes using real-world studies.
总结高强度他汀类药物的头对头研究在疗效和安全性方面的证据，无论其潜在人群如何。系统回顾和荟萃分析旨在总结比较高强度他汀类药物的随机对照试验和队列研究中的效果大小。基于 44 篇文章，从基线水平降低 LDL 水平方面，所有他汀类药物的效果相似。所有他汀类药物都观察到具有相似的药物不良反应 (ADR)，尽管高剂量与更多的 ADR 相关。基于阿托伐他汀 80mg 与瑞舒伐他汀 40mg 的汇总定量分析，瑞舒伐他汀在降低 LDL 方面具有统计学上的更大效果。本综述进一步证实，高强度他汀类药物可将 LDL 降低≥50%，瑞舒伐他汀优于阿托伐他汀。需要更多的数据来确认使用真实世界研究的心血管结局的临床意义。
