Comparative efficacy and safety among high-intensity statins. Systematic Review and Meta-Analysis

Jaam, Myriam; Al-Naimi, Hend; Haddad, Moumena Mahmoud; Abushanab, Dina; Al‐Badriyeh, Daoud

doi:10.57264/cer-2022-0163

Cited by 4 publications

(2 citation statements)

References 79 publications

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“…A meta-analysis of 50 studies, with a total of 51,956 patients, analyzed the effectiveness of different statins in reducing LDL-C levels, with rosuvastatin being found the most potent statin [28]. This superiority has been confirmed in a more recent meta-analysis [29]. Nonetheless, rosuvastatin dosage reductions have been recommended in Asian patients, as it has been observed in pharmacokinetic studies that there is a two-fold increase in median exposure to rosuvastatin in Asian subjects when compared to Caucasian individuals [30,31].…”

Section: Efficacymentioning

confidence: 94%

Rosuvastatin-Based Lipid-Lowering Therapy for the Control of LDL Cholesterol in Patients at High Vascular Risk

Mostaza,

Escobar

2024

JCM

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Vascular diseases are the leading cause of death in Spain. Hypercholesterolemia is not only a cardiovascular risk factor, but also underlies the etiopathogenesis of atherosclerosis. Therefore, reducing LDL cholesterol (LDL-C) to the goals recommended by clinical practice guidelines, is essential to decrease the risk of vascular complications. Despite this, current LDL-C control is scarce, even in subjects with high and very high risk. This is mainly due to an insufficient intensification of lipid-lowering treatment. In this context, it is essential to prescribe the appropriate therapy, adjusted to patient’s needs based on their LDL-C and their vascular risk. Rosuvastatin, alone or in combination with ezetimibe, provides intensive LDL-C reductions (up to 50–55% and 60–75%, respectively), with a low risk of side effects and in an efficient manner, in patients both without and with established atherosclerotic vascular disease.

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Section: Efficacymentioning

confidence: 94%

Rosuvastatin-Based Lipid-Lowering Therapy for the Control of LDL Cholesterol in Patients at High Vascular Risk

Mostaza,

Escobar

2024

JCM

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“…Современные зарубежные и российские клинические рекомендации определяют как целевой уровень холестерина липопротеидов низкой плотности (ХС ЛНП) у пациентов с высоким уровнем риска ниже 1,8 ммоль/л, у пациентов с очень высоким риском -ниже 1,4 ммоль/л и ниже 1,0 ммоль/л у пациентов с экстремально высоким риском [3,4]. Но у части пациентов всё же не удаётся достигнуть необходимых целевых уровней ХС ЛНП, даже несмотря на высокодозную терапию статинами, в том числе и при наследственной ГХС [5]. В связи с этим имеется необходимость интенсификации липидснижающей терапии за счёт добавления в вышеупомянутую программу лекарственных препаратов с иным механизмом действия, имеющих определённые дополнительные клинические преимущества по сравнению со статинами.…”

Section: введение / Introductionunclassified

Economic aspects of the cardiology program expansion of additional drugs provision by effective lipidlowering drugs for hypercholesterolemia control

Obuhova,

Bogomazova,

Meshkov

et al. 2024

GCP

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The federal program of preferential drug provision in cardiology shows its effectiveness. However, hypercholesterolemia (HCH) remains a significant problem in patients in whom high-dose statin therapy does not provide the target level of low-density lipoprotein cholesterol (LDL cholesterol). The solution to the problem lies in the plane of prescribing lipid-lowering drugs of a different mechanism of action, for example, inhibitors of the PCSK9 enzyme. To recommend the inclusion of such kind drugs in the program, it is necessary not only to have evidence of their life-saving effect, but also the economic feasibility of their use. Aim: to evaluate the economic efficacy of alirocumab (INN) including in the federal program for patients who have suffered an acute coronary event, are receiving statins and have an LDL CH level of 5.0 mmol/l and higher.Materials and methods. Modeling was applied in a target group of 3029 patients of working age who had undergone ACS during the previous 12 months with severe, including familial, HCH, with LDL cholesterol 5.0 mmol/l and higher, receiving statins taking into account previously determined outcomes when using alirocumab + statins for 5 years. Direct medical and non-medical costs, as well as indirect costs, are identified. The cost-effectiveness analysis was applied from the point of view of the effectiveness of treatment (effects on mortality, temporary disability, disability) and direct health care costs (additional drug provision and outpatient follow-up, specialized, including high-tech, medical care in a 24‑hour hospital). Two healthcare technologies were compared: statin therapy and use of alirocumab + statins. The calculations used according to domestic methods used the cost of medical treatment, temporary disability, hospitalizations, loss of GDP and other parameters.Results. Modeling has shown a decrease in mortality, morbidity and disability when using alirocumab in even the first year of use. The economic effect of alirocumab from a decrease in temporary disability in the 1st year is 304.5 mln rub., in the 2nd — 301.5 mln rub., in the 3rd — 321.1 mln rub., in the 4th — 333.1 mln rub. The estimated amount of prevented GDP losses from mortality in the target group for 4 years in the case of alirocumab use amounted to 1,260.2 mln rub. The annual amount of avoidable GDP losses from mortality in the target group in the case of alirocumab is 27–30 %. The annual average savings per patient in the case of alirocumab use are from 7 to 17 %. The greatest impact on reducing losses from disability and mortality of the target group is noted in the group of people aged 40–59 years. Only for this group, if alirocumab is used, it is possible to reduce losses from disability and mortality by 159.2 million rubles per year (83 % of the total economic effect). Starting from the 4th year of alirocumab use, it is possible to obtain a positive economic effect in terms of hospitalization costs.Conclusion. When alirocumab is included in the program of additional drug provision in cardiology, the share of costs for the purchase of alirocumab for the target group may be only 0.01 %. At the same time, the economic effect of inclusion in the first year alone will amount to at least 393.4 million rubles of budget funds. The total amount of avoidable losses due to the alirocumab usage may amount to 1,638 million rubles over 4 years.

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Statins and new-onset diabetes in primary prevention setting: an updated meta-analysis stratified by baseline diabetes risk

Masson,

Lobo,

Barbagelata

et al. 2023

Acta Diabetol

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Comparative efficacy and safety among high-intensity statins. Systematic Review and Meta-Analysis

Cited by 4 publications

References 79 publications

Rosuvastatin-Based Lipid-Lowering Therapy for the Control of LDL Cholesterol in Patients at High Vascular Risk

Rosuvastatin-Based Lipid-Lowering Therapy for the Control of LDL Cholesterol in Patients at High Vascular Risk

Economic aspects of the cardiology program expansion of additional drugs provision by effective lipidlowering drugs for hypercholesterolemia control

Statins and new-onset diabetes in primary prevention setting: an updated meta-analysis stratified by baseline diabetes risk

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