Abstract
The primary objective of this 6-week, parallel-group, open-label, randomized, multicenter trial was to compare rosuvastatin with atorvastatin, pravastatin, and simvastatin across dose ranges for reduction of low-density lipoprotein (LDL) cholesterol. Secondary objectives included comparing rosuvastatin with comparators for other lipid modifications and achievement of National Cholesterol Education Program Adult Treatment Panel III and Joint European Task Force LDL cholesterol goals. After a dietary lead-in period, 2,431 adults with hypercholesterolemia (LDL cholesterol > or =160 and <250 mg/dl; triglycerides <400 mg/dl) were randomized to treatment 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. At 6 weeks, across-dose analyses showed that rosuvastatin 10 to 80 mg reduced LDL cholesterol by a mean of 8.2% more than atorvastatin 10 to 80 mg, 26% more than pravastatin 10 to 40 mg, and 12% to 18% more than simvastatin 10 to 80 mg (all p <0.001). Mean percent changes in high-density lipoprotein cholesterol in the rosuvastatin groups were +7.7% to +9.6% compared with +2.1% to +6.8% in all other groups. Across dose ranges, rosuvastatin reduced total cholesterol significantly more (p <0.001) than all comparators and triglycerides significantly more (p <0.001) than simvastatin and pravastatin. Adult Treatment Panel III LDL cholesterol goals were achieved by 82% to 89% of patients treated with rosuvastatin 10 to 40 mg compared with 69% to 85% of patients treated with atorvastatin 10 to 80 mg; the European LDL cholesterol goal of <3.0 mmol/L was achieved by 79% to 92% in rosuvastatin groups compared with 52% to 81% in atorvastatin groups. Drug tolerability was similar across treatments.
Keywords
RosuvastatinPravastatinSimvastatinAtorvastatinMedicineStatinHMG-CoA reductaseCholesterolNational Cholesterol Education ProgramRosuvastatin CalciumInternal medicineUrologyEndocrinologyPharmacologyReductaseChemistryBiochemistryEnzymeMetabolic syndrome
MeSH Terms
AdultAgedAged80 and overAtorvastatinCholesterolLDLDose-Response RelationshipDrugFemaleFluorobenzenesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsHypercholesterolemiaMaleMiddle AgedPravastatinPyrimidinesPyrrolesRosuvastatin CalciumSimvastatinSulfonamidesTime Factors
Affiliated Institutions
Related Publications
Comparison of Once-Daily, niacin Extended-Release/lovastatin with standard doses of atorvastatin and simvastatin (the advicor versus other Cholesterol-Modulating agents trial evaluation [ADVOCATE])
This study compared the relative efficacy of a once-daily niacin extended-release (ER)/lovastatin fixed-dose combination with standard doses of atorvastatin or simvastatin, with...
Once‐daily pravastatin in patients with primary hypercholesterolemia: A dose‐response study
Abstract This multicenter, double‐blind, placebo‐controlled study was conducted to evaluate dose‐response effects and safety of once‐daily administration of pravastatin, a new i...
Statins: Beneficial or Adverse for Glucose Metabolism
Large-scale clinical trials have established that statin use for lowering blood cholesterol is beneficial in reducing atherosclerotic cardiovascular diseases in different popula...
Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis
Statins can lower LDL cholesterol concentration by an average of 1.8 mmol/l which reduces the risk of IHD events by about 60% and stroke by 17%.
Achievement of Dual Low-Density Lipoprotein Cholesterol and High-Sensitivity C-Reactive Protein Targets More Frequent With the Addition of Ezetimibe to Simvastatin and Associated With Better Outcomes in IMPROVE-IT
Background— Statins lower low-density lipoprotein cholesterol (LDL-C) and high-sensitivity C-reactive protein (hs-CRP); addition of ezetimibe to statins further reduces LDL-C an...
Publication Info
- Year
- 2003
- Type
- article
- Volume
- 92
- Issue
- 2
- Pages
- 152-160
- Citations
- 1382
- Access
- Closed
External Links
Social Impact
Altmetric
PlumX Metrics
Social media, news, blog, policy document mentions
Citation Metrics
1382
OpenAlex
6
Influential
1083
CrossRef
Cite This
Peter H. Jones,
Michael H. Davidson,
Evan A. Stein
et al.
(2003).
Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR**STELLAR = Statin Therapies for Elevated Lipid Levels compared Across doses to Rosuvastatin. Trial).
The American Journal of Cardiology
, 92
(2)
, 152-160.
https://doi.org/10.1016/s0002-9149(03)00530-7
Identifiers
- DOI
- 10.1016/s0002-9149(03)00530-7
- PMID
- 12860216