LDL Cholesterol Reduction Variability with Different Types and Doses of Statins in Monotherapy or Combined with Ezetimibe. Results from the Spanish Arteriosclerosis Society Dyslipidaemia Registry

Abstract

Low-density lipoprotein (LDL) cholesterol reduction by statin therapy is dose-dependent, varies among different statins and has wide inter-individual variability.The present study aimed to compare mean LDL cholesterol reduction achieved with different doses of the three statins most frequently used in monotherapy, or combined with ezetimibe, in a real clinical setting.Methods: Of 5,620 cases with primary hypercholesterolaemia on the Spanish Arteriosclerosis Society Registry, 1,004 corresponded to non-monogenic hypercholesterolaemia and complete information on drug therapy and lipid profile were included. Results:The lowest mean percentage LDL cholesterol reduction was observed with simvastatin 10 mg (32.5 ± 18.5%) while the highest mean percentage LDL reduction was obtained with rosuvastatin 40 mg (58.7 ± 18.8%). As to combined treatment, the lowest and highest mean percentage LDL cholesterol reductions were obtained with simvastatin 10 mg combined with ezetimibe (50.6 ± 24.6%) and rosuvastatin 40 mg combined with ezetimibe (71.6 ± 11.1%), respectively. Factors associated with a suboptimal response were male sex, age, body mass index and baseline LDL cholesterol levels. Combined treatment was associated with less variability in LDL cholesterol reduction (OR 0.603, p < 0.001). Conclusion:In a real clinical setting, rosuvastatin was superior to the other statins in lowering LDL cholesterol, both as monotherapy or combined with ezetimibe. Factors associated with a suboptimal response in LDL cholesterol included sex, age, body mass index and baseline LDL cholesterol levels. Combined treatment was associated with less variability in LDL cholesterol improvement.

The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…In Figure 2 B, LDL-C responses to exercise+statin compared with exercise+placebo groups exhibited a high heterogeneity likely because of expected intraindividual variability in baseline LDL-C levels and various statin dosages or types. 37 …”

Short-Course High-Intensity Statin Treatment during Admission for Myocardial Infarction and LDL-Cholesterol Reduction—Impact on Tailored Lipid-Lowering Therapy at Discharge

“…To analyze the potency for LDL-C reduction in each LLT ( Table S1 ), we used data from the National Institute for Health and Care Excellence (NICE) guidelines [ 13 ], the University of Michigan (UMHS) Lipid Therapy Guideline [ 14 ], the American 2018 Guideline on the Management of Blood Cholesterol [ 15 ], the Cochrane Collaboration [ 16 , 17 , 18 ], Spanish real-life registries [ 19 ], and several clinical trials, reviews and information from real clinical practice [ 20 , 21 , 22 , 23 , 24 , 25 , 26 ]. If no specific data were found regarding an exact combination of drugs, we used the formula for multiple percentage changes [ 27 ], which reads: Final LDL-C with LLT = Initial LDL-C × (1 − % reduction with drug #1) × (1 − % reduction with drug #2) × (1 − % reduction with drug #3) × (1 − % reduction with drug #4) …”

Análisis de coste-consecuencia de rosuvastatina frente a atorvastatina en el contexto español

“…En el entorno español, se dispone de diferentes registros sobre pacientes con hipercolesterolemia como el Registro de dislipidemia de la Sociedad Española de Arteriosclerosis (SEA) y el SAFEHEART (Spanish Familial Hypercholesterolaemia Cohort Study) 14,15 . Recientemente, se han publicado datos del registro de la SEA sobre la reducción de los niveles de cLDL en pacientes con hipercolesterolemia familiar heterocigota (HFHe) y la hipercolesterolemia no familiar o poligénica (no-HF) 16,17 . A partir de estos datos, el objetivo de este estudio es determinar las dosis equipotentes de rosuvastatina y atorvastatina en monoterapia, y estimar el impacto económico derivado de la sustitución terapéutica en pacientes con riesgo CV alto o muy alto tratados con estatinas a dosis altas en España.…”