LDL-C reductions and goal attainment among naive statin users in the Netherlands: real life results

LDL-C reductions and goal attainment among naive statin users in the Netherlands: real life results

ABSTRACT Objective: The effectiveness of statin therapy in a real life setting may differ from that in clinical trials, as physicians make non-randomised treatment decisions for patients with less uniform and possibly different characteristics. We therefore performed a study to compare the effective...

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Published in:Current medical research and opinion Vol. 24; no. 8; pp. 2241 - 2250
Main Authors: Heintjes, Edith M., Hirsch, Mark W., van der Linden, Michiel W., O‘Donnell, John C., Stalenhoef, Anton F., Herings, Ron M. C.
Format: Journal Article
Language:English
Published: England Informa UK Ltd 01-08-2008
Taylor & Francis
Subjects:
Aged
Cholesterol
Cholesterol, LDL - blood
Cohort Studies
Female
Goal attainment
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypercholesterolemia - drug therapy
LDL-C reduction
Male
Middle Aged
Netherlands
Risk Factors
Statins
Treatment Outcome
Netherlands
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Summary:ABSTRACT Objective: The effectiveness of statin therapy in a real life setting may differ from that in clinical trials, as physicians make non-randomised treatment decisions for patients with less uniform and possibly different characteristics. We therefore performed a study to compare the effectiveness of different statins and doses in routine clinical practice with respect to total serum cholesterol and LDL-cholesterol (LDL-C) reduction and goal attainment according to European guidelines on the prevention of cardiovascular disease (CVD). Research design and methods: Naive statin users starting treatment in 2003 and 2004 with LDL-C measurements at baseline and between 30 and 365 days after start of treatment were extracted from the PHARMO database. During treatment with their initial statin dose LDL-C reduction and attainment of cholesterol goals were compared between different statins and doses. Results: Of 2303 identified naive patients, approximately 30% were allocated to the high CVD-risk group. Average LDL-C reductions were 48%, 42%, 39%, and 32% at mean doses of 11 mg rosuvastatin, 17 mg atorvastatin, 22 mg simvastatin and 35 mg pravastatin, respectively. The proportion of patients attaining cholesterol goals was 75% for rosuvastatin, 68% for atorvastatin, 56% for simvastatin, and 42% for pravastatin. Dose comparisons showed greater LDL-C reduction and increased goal attainment for rosuvastatin 10 mg compared to other statins at most doses (adjusted p < 0.05). Conclusions: In a real life setting, both LDL-C reduction and the proportion of patients attaining cholesterol goals appear to be significantly increased among users of rosuvastatin compared to other statins. These results confirm and extend reported clinical trial results to a real world setting.
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ISSN:0300-7995
1473-4877
DOI:10.1185/03007990802264487