Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial

• Published in: Current medical research and opinion Vol. 19; no. 8; pp. 689 - 698
• Main Authors: McKenney, James M., Jones, Peter H., Adamczyk, M. Angeli, Cain, Valerie A., Bryzinski, Brian S., Blasetto, James W.
• Format: Journal Article
• Language: English
• Published: Reading Informa UK Ltd 2003; Taylor & Francis; Librapharm; Informa Healthcare
• Subjects: Anticholesteremic Agents - therapeutic use; Atorvastatin Calcium; Biological and medical sciences; Cholesterol lowering; Cholesterol, LDL - blood; Female; Fluorobenzenes - therapeutic use; General and cellular metabolism. Vitamins; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypercholesterolemia; Hypercholesterolemia - blood; Hypercholesterolemia - drug therapy; Low-density lipoprotein cholesterol; Male; Medical sciences; Middle Aged; North America; Pharmacology. Drug treatments; Pravastatin - therapeutic use; Pyrimidines - therapeutic use; Pyrroles - therapeutic use; Rosuvastatin; Rosuvastatin Calcium; Simvastatin - therapeutic use; Statins; Sulfonamides - therapeutic use; North America; Human; Enzyme; Treatment efficiency; Simvastatin; Enzyme inhibitor; Metabolic diseases; Lipids; Hyperlipoproteinemia; Statin derivative; Rosuvastatin; Pravastatin; Low-density lipoprotein cholesterol; Cholesterol lowering; Chemotherapy; Hypercholesterolemia; Treatment; Atorvastatin; Hydroxymethylglutaryl-CoA reductase; Clinical trial; Oxidoreductases; Dyslipemia; Comparative study; Statins; Antilipemic agent
• ISSN: 0300-7995; 1473-4877
• DOI: 10.1185/030079903125002405

SUMMARY In the Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin (STELLAR) trial, the efficacy of rosuvastatin calcium (Crestor*) was compared with that of atorvastatin (Lipitor †), simvastatin (Zocor‡), and pravastatin (Pravachol§) for lowering plasma low-density lipoprotein cholesterol (LDL-C) after 6 weeks of treatment. In this multicenter, parallel-group, open-label trial, adults with hypercholesterolemia were randomized to treatments with rosuvastatin 10, 20,40, or 80 mg, atorvastatin 10, 20,40, or 80 mg, simvastatin 10,20,40, or 80 mg, or pravastatin 10, 20, or 40 mg. Efficacy and safety results from this trial have been previously published. The additional analyses included in this report show that 53% (83/156) to 80% (125/157) of patients in the rosuvastatin 10- to 40-mg groups achieved LDL-C levels <100 mg dl−1 (<2.6 mmol l−1), compared with 18% (28/158) to 70% (115/165) of patients who received atorvastatin, 8% (13/165) to 53% (86/163) of patients who received simvastatin, and 1% (1/160) to 8% (13/161) of patients who received pravastatin. Other additional analyses showed that more patients in the rosuvastatin 10- to 40-mg groups than in the comparator groups who were at high risk of coronary heart disease according to National Cholesterol Education Program Adult Treatment Panel (ATP) III, Joint European Societies, or Canadian guidelines achieved the LDL-C goals of <100 mg dl−1 (<2.6 mmol l−1) (55% to 77% compared with 0 to 64%), <3.0 mmol l−1 (<116 mg dl−1) (76% to 94% compared with 6% to 81%), and <2.5 mmol l−1 (<97mg dl−1) (47% to 69% compared with 0 to 53%), respectively. Results favoring rosuvastatin versus the comparators were also reported for patients: (a) who had triglycerides >200 mg dl−1 (>2.3 mmol l−1), and achieved both ATP III LDL-C and non-high-density lipoprotein cholesterol (non-HDL-C) goals (80% to 84% versus 15% to 84%); (b) overall who achieved the Canadian LDL-C goals of <2.5 (<97 mg dl−1) to <5.0 mmol l−1 (< 193mg/dl) (85% to 91% versus 44% to 86%); and (c) who achieved all 3 Canadian goals for LDL-C, triglycerides (<3.0 mmol l−1 [< 266 mg dl−1] to < 2.0 mmol l−1 [<177 g dl−1]), and the total cholesterol/high-density lipoprotein-cholesterol ratio (<4 to <7) (70% to 83% versus 35% to 79%). *Crestor is a registered trademark of the AstraZeneca group of companies and is licensed to AstraZeneca from Shionogi & Co, Ltd, Osaka, Japan. †Lipitor is a registered trademark of Pfizer Inc. ‡ Zocor is a registered trademark of Merck & Co., Inc. §Pravachol is a registered trademark of Bristol-Myers Squibb Company.