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Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care.
Expert Opin Pharmacother. 2008 Apr; 9(5):669-76.EO

Abstract

OBJECTIVE

To compare change in low-density lipoprotein cholesterol (LDL-C) levels and National Cholesterol Education Program (NCEP) Adult Treatment Panel III LDL-C goal attainment in diabetic patients treated with rosuvastatin versus other statins in a large, managed care health plan.

RESEARCH DESIGN AND METHODS

This retrospective cohort analysis used medical and pharmacy claims linked to laboratory results from a commercial/MedicareAdvantage health plan. Study participants were >or= 18 years of age, had a diagnosis of diabetes, were newly treated with statins from 8/1/03 to 2/28/05, and were considered at high risk for cardiovascular events as defined by NCEP guidelines. Subjects were continuously enrolled for 12 months pre-index and >or= 30 days post-index, with variable follow-up until therapy discontinuation or end of health plan eligibility.

MAIN OUTCOME MEASURES

Change in LDL-C from baseline, and attainment of NCEP LDL-C goal among patients not at goal before starting therapy.

RESULTS

A total of 3337 adult patients with diabetes were identified with new use of statin therapy during the identification period. A total of 9% (n = 301) started on rosuvastatin, 49.4% (n = 1,649) on atorvastatin, 20.7% (n = 690) on simvastatin, 7.0% (n = 234) on pravastatin, 11.7% (n = 391) on lovastatin and 2.2% (n = 72) on fluvastatin. After controlling for covariates, rosuvastatin patients experienced a significantly greater decrease in LDL-C from baseline (38.7%) than patients taking atorvastatin (34.2%) (p = 0.05), simvastatin (31.5%), pravastatin (24.2%), fluvastatin (26.3%) or lovastatin (24.9%) (p < 0.0001). Rosuvastatin users were significantly more likely to attain LDL-C goal than those taking the other statins (odds ratio: 0.44, 0.28, 0.14, 0.14, 0.19, respectively; p < 0.001). Predicted percent attaining goal was significantly greater for those taking rosuvastatin (87.3%) than for those taking atorvastatin (76.9%), simvastatin (68.7%), pravastatin (55.0%), lovastatin (55.3%) or fluvastatin (61.3%) (p < 0.001).

CONCLUSION

For diabetic patients, rosuvastatin is more effective at reducing LDL-C levels and attaining NCEP ATP III LDL-C goal than other statins in real-world clinical practice.

Authors+Show Affiliations

i3 Innovus, Health Economics & Outcomes Research, 12125 Technology Drive, Eden Prairie, MN 55344, USA. carolyn.harley@i3innovus.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18345946

Citation

Harley, Carolyn R., et al. "Lipid Levels and Low-density Lipoprotein Cholesterol Goal Attainment in Diabetic Patients: Rosuvastatin Compared With Other Statins in Usual Care." Expert Opinion On Pharmacotherapy, vol. 9, no. 5, 2008, pp. 669-76.
Harley CR, Gandhi SK, Heien H, et al. Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care. Expert Opin Pharmacother. 2008;9(5):669-76.
Harley, C. R., Gandhi, S. K., Heien, H., McDonough, K., & Nelson, S. P. (2008). Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care. Expert Opinion On Pharmacotherapy, 9(5), 669-76. https://doi.org/10.1517/14656566.9.5.669
Harley CR, et al. Lipid Levels and Low-density Lipoprotein Cholesterol Goal Attainment in Diabetic Patients: Rosuvastatin Compared With Other Statins in Usual Care. Expert Opin Pharmacother. 2008;9(5):669-76. PubMed PMID: 18345946.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Lipid levels and low-density lipoprotein cholesterol goal attainment in diabetic patients: rosuvastatin compared with other statins in usual care. AU - Harley,Carolyn R, AU - Gandhi,Sanjay K, AU - Heien,Herbert, AU - McDonough,Ken, AU - Nelson,Stephanie P, PY - 2008/3/19/pubmed PY - 2008/4/11/medline PY - 2008/3/19/entrez SP - 669 EP - 76 JF - Expert opinion on pharmacotherapy JO - Expert Opin Pharmacother VL - 9 IS - 5 N2 - OBJECTIVE: To compare change in low-density lipoprotein cholesterol (LDL-C) levels and National Cholesterol Education Program (NCEP) Adult Treatment Panel III LDL-C goal attainment in diabetic patients treated with rosuvastatin versus other statins in a large, managed care health plan. RESEARCH DESIGN AND METHODS: This retrospective cohort analysis used medical and pharmacy claims linked to laboratory results from a commercial/MedicareAdvantage health plan. Study participants were >or= 18 years of age, had a diagnosis of diabetes, were newly treated with statins from 8/1/03 to 2/28/05, and were considered at high risk for cardiovascular events as defined by NCEP guidelines. Subjects were continuously enrolled for 12 months pre-index and >or= 30 days post-index, with variable follow-up until therapy discontinuation or end of health plan eligibility. MAIN OUTCOME MEASURES: Change in LDL-C from baseline, and attainment of NCEP LDL-C goal among patients not at goal before starting therapy. RESULTS: A total of 3337 adult patients with diabetes were identified with new use of statin therapy during the identification period. A total of 9% (n = 301) started on rosuvastatin, 49.4% (n = 1,649) on atorvastatin, 20.7% (n = 690) on simvastatin, 7.0% (n = 234) on pravastatin, 11.7% (n = 391) on lovastatin and 2.2% (n = 72) on fluvastatin. After controlling for covariates, rosuvastatin patients experienced a significantly greater decrease in LDL-C from baseline (38.7%) than patients taking atorvastatin (34.2%) (p = 0.05), simvastatin (31.5%), pravastatin (24.2%), fluvastatin (26.3%) or lovastatin (24.9%) (p < 0.0001). Rosuvastatin users were significantly more likely to attain LDL-C goal than those taking the other statins (odds ratio: 0.44, 0.28, 0.14, 0.14, 0.19, respectively; p < 0.001). Predicted percent attaining goal was significantly greater for those taking rosuvastatin (87.3%) than for those taking atorvastatin (76.9%), simvastatin (68.7%), pravastatin (55.0%), lovastatin (55.3%) or fluvastatin (61.3%) (p < 0.001). CONCLUSION: For diabetic patients, rosuvastatin is more effective at reducing LDL-C levels and attaining NCEP ATP III LDL-C goal than other statins in real-world clinical practice. SN - 1744-7666 UR - https://www.unboundmedicine.com/medline/citation/18345946/Lipid_levels_and_low_density_lipoprotein_cholesterol_goal_attainment_in_diabetic_patients:_rosuvastatin_compared_with_other_statins_in_usual_care_ L2 - https://www.tandfonline.com/doi/full/10.1517/14656566.9.5.669 DB - PRIME DP - Unbound Medicine ER -