Cholesterol‐lowering effects of rosuvastatin compared with atorvastatin in patients with type 2 diabetes – CORALL study

Abstract

Subjects. A total of 263 patients with type 2 diabetes treated with oral agents or insulin, age (mean ± SD) 60 ± 10 years, body mass index (BMI) 31.4 ± 6.1 kg m )2 , 46% males. Intervention. After a 6-week dietary lead-in period, patients were randomized to RSV (n ¼ 131) or ATV (n ¼ 132) treatment in a dose escalation scheme (RSV: 10, 20 and 40 mg or ATV: 20, 40 and 80 mg for 6 weeks each sequentially). Main outcome measures. Primary outcome was the change in apolipoprotein B (apoB) and apoB/ apolipoprotein A1 (apoA1) ratio, which has been suggested a better predictor for cardiovascular events than total (TC) or low-density lipoprotein cholesterol (LDL-C). Secondary outcomes were the changes in other lipid parameters. Results. Baseline LDL-C in the RSV and ATV groups was 4.23 ± 0.98 mmol L )1 and 4.43 ± 0.99 mmol L )1 , whilst apoB/apoA1 was 0.86 ± 0.22 and 0.92 ± 0.35, respectively. A greater reduction in apoB/apoA1 was seen with RSV ()34.9%, )39.2% and )40.5%) than with ATV ()32.4%, )34.7% and )35.8%, P < 0.05 at weeks 12 and 18). Significantly greater reductions in LDL-C were also seen with RSV ()45.9%, )50.6% and )53.6%) than with ATV ()41.3%, )45.6% and )47.8%, all P < 0.05). The American Diabetes Association (ADA) LDL-C goal of <2.6 mmol L )1 was reached by 82%, 84% and 92% of patients with RSV and 74%, 79% and 81% with ATV. Triglyceride reductions ranged from 16 to 24% and were not different between treatments. Both treatments were well-tolerated: nine patients in the RSV and 11 in the ATV group withdrew from treatment because of adverse events after randomization. Conclusion. In subjects with type 2 diabetes, greater improvements of apoB/apoA1 and across the lipid profile were observed with RSV compared with ATV.

The effects of statins on high-density lipoproteins

“…Significantly greater reductions in LDL cholesterol were observed with rosuvastatin at 45.9%, 50.6%, and 53.6% as compared with atorvastatin, where the reductions were 41.3%, 45.6%, and 47.8%. The same was the case for reductions in the apoB to apoA-I ratio, which were 34.9%, 39.2%, and 40.5% for rosuvastatin, and 32.4%, 34.7%, and 35.8% for atorvastatin [24]. Rosuvastatin also caused significantly greater increases in HDL cholesterol and apoA-I than did atorvastatin, especially at maximal doses in these diabetic subjects [24].…”

“…Wolfenbuttel et al [24] compared lipid-modifying effects of rosuvastatin and atorvastatin in 263 patients with type 2 diabetes that were being treated either with oral agents, insulin, or both. These patients underwent escalating doses of 10, 20, and 40 mg/d of rosuvastatin or 20, 40, and 80 mg/d of atorvastatin.…”

Safety of Rosuvastatin: Update on 16,876 Rosuvastatin-Treated Patients in a Multinational Clinical Trial Program

“…Additionally, in various patient populations, rosuvastatin provided comparable or greater improvements in other atherogenic lipid measures and in achievement of lipid goals [19,26,27,28]. Moreover, switching to rosuvastatin from equivalent or higher doses of comparator statins has been shown to improve lipid goal achievement rates in high-risk patients compared with patients who did not switch [29, 30].…”

The Possibilities of Using a New Fixed-Dose Combination of Rosuvastatin and Acetylsalicylic Acid: Focus Groups of Patients

“…На сегодняшний день наиболее эффективным статином в отношении снижения уровня ХС-ЛПНП считается розувастатин, что было выявлено в ряде исследований (STELLAR, ANDROMEDA, POLARIS, CORALL, URANUS и др.) [39][40][41][42][43]. Особенно четко это продемонстрировано в исследовании STELLAR (Comparison of the Efficacy and Safety of Rosuvastatin Versus Atorvastatin, Simvastatin, and pravastatin Across Doses) [39], в которое были включены пациенты с гиперхолестеринемией, в том числе, пациенты с ИБС, перенесенным ИМ, ИИ или ТИА в анамнезе, заболеваниями периферических ар-терий.…”