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Ros4.5

Rosuvastatin (Crestor) – Forschung

Überwiegend Mechanismus / Beobachtung

6 begutachtete Studien

Was die Evidenz sagt

Überwiegend Mechanismus / Beobachtung

Die meisten Studien zu Rosuvastatin (Crestor) sind mechanistisch oder beobachtend statt RCTs, die einen klinischen Effekt messen — betrachte die Ergebnisse als vorläufig.

Die meiste Evidenz stammt aus hochwertigen Meta-Analysen und randomisierten Studien, veröffentlicht 2006–2011 mit einer typischen Studiengröße von 1,039 Teilnehmenden.

Basierend auf 6 Studien · 2 Meta-Analysen · 3 RCTs · 111,472 Teilnehmende insgesamt

Konfidenz

Hohe Konfidenz

Nach Outcome

Cardiovascular events & plaqueIn JUPITER reduzierte schwerwiegende kardiovaskuläre Ereignisse um ~44% und die Gesamtmortalität um ~20% in der Primärprävention; serielle IVUS-Studien zeigen eine Regression koronarer Plaques · Monate bis Jahre (LDL-Senkung innerhalb von 2-4 Wochen)
Überwiegend Mechanismus / Beobachtung6 Studien
LDL & lipid loweringIn JUPITER reduzierte schwerwiegende kardiovaskuläre Ereignisse um ~44% und die Gesamtmortalität um ~20% in der Primärprävention; serielle IVUS-Studien zeigen eine Regression koronarer Plaques · Monate bis Jahre (LDL-Senkung innerhalb von 2-4 Wochen)
Überwiegend Mechanismus / Beobachtung4 Studien
Glucose & metabolic
Zu wenige bewertete Studien2 Studien

Ältere Forschungsbasis

Neueste Studie von 2011 · Neueste Meta-Analyse: 2010

20062011

1RCTn=17,802 · very large study2008

Rosuvastatin reduced LDL cholesterol by 50% and significantly reduced major cardiovascular events and all-cause mortality in apparently healthy people with elevated high-sensitivity CRP.

Ridker, Danielson, Fonseca, Genest, Gotto, Kastelein · The New England journal of medicine (2008)

JUPITER randomized placebo-controlled primary-prevention trial (~17,800 participants with normal LDL but elevated hsCRP)
Rosuvastatin 20 mg lowered LDL-C by ~50% and reduced the primary composite endpoint (hazard ratio 0.56)
Reduced myocardial infarction, stroke, and revascularization individually, plus all-cause mortality (hazard ratio 0.80)

Quelle ansehen

2Meta-Analyse2010

Each 1.0 mmol/L reduction in LDL cholesterol reduced the annual rate of major vascular events by just over a fifth, with no evidence of a lower limit of benefit.

Cholesterol Treatment Trialists' (CTT) Collaboration; Baigent, Blackwell, Emberson, Reith, Bhala · Lancet (London, England) (2010)

Meta-analysis of ~170,000 participants across 26 randomized statin trials
Each ~1.0 mmol/L LDL-C reduction cut major vascular events by ~22% (RR 0.78)
Benefit extended to patients with baseline LDL below 2 mmol/L — 'lower is better'

Quelle ansehen

3RCTn=1,039 · large study2011

Rosuvastatin 40 mg achieved lower LDL cholesterol and more favorable regression of total atheroma volume than atorvastatin 80 mg.

Nicholls, Ballantyne, Barter, Chapman, Erbel, Libby · The New England journal of medicine (2011)

SATURN randomized head-to-head IVUS trial (1,039 patients) comparing rosuvastatin 40 mg vs atorvastatin 80 mg
Rosuvastatin achieved lower LDL-C (62.6 vs 70.2 mg/dL) after 104 weeks
Both regimens regressed percent atheroma volume; rosuvastatin produced more favorable total-atheroma-volume regression

Quelle ansehen

4Meta-Analysen=91,140 · very large study2010

Statin therapy was associated with a 9% increased risk for incident diabetes, a small absolute risk relative to the cardiovascular benefit.

Sattar, Preiss, Murray, Welsh, Buckley, de Craen · Lancet (London, England) (2010)

Collaborative meta-analysis of randomized statin endpoint trials (~91,000 participants, 13 trials)
Statin therapy raised new-onset diabetes risk by ~9% (odds ratio 1.09)
Absolute risk was low and outweighed by cardiovascular event reduction in higher-risk patients

Quelle ansehen

5Open-Labeln=507 · large study2006

Very high-intensity rosuvastatin produced convincing evidence of regression of coronary atherosclerosis on intravascular ultrasound.

Nissen, Nicholls, Sipahi, Libby, Raichlen, Ballantyne · JAMA (2006)

ASTEROID open-label IVUS trial (507 enrolled; 349 with evaluable serial imaging)
Rosuvastatin 40 mg markedly lowered LDL-C and raised HDL-C over 24 months
Demonstrated regression of percent atheroma volume — the most rigorous IVUS measure

Quelle ansehen

6RCTn=984 · large study2007

Rosuvastatin 40 mg significantly slowed progression of carotid intima-media thickness over 2 years in low-risk individuals with subclinical atherosclerosis.

Crouse, Raichlen, Riley, Evans, Palmer, O'Leary · JAMA (2007)

METEOR randomized placebo-controlled trial (984 low-risk individuals with subclinical carotid atherosclerosis)
Rosuvastatin 40 mg over 2 years halted progression of carotid intima-media thickness vs placebo
Demonstrated an anti-atherosclerotic imaging effect even in lower-risk people

Quelle ansehen

In der Forschungsbibliothek ansehen

Rosuvastatin (Crestor) – Forschung

Überwiegend Mechanismus / Beobachtung

Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein.

Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials.

Effect of two intensive statin regimens on progression of coronary disease.

Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials.

Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial.

Effect of rosuvastatin on progression of carotid intima-media thickness in low-risk individuals with subclinical atherosclerosis: the METEOR Trial.