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DYSLIPIDEMIA

Efficacy and Safety of Rosuvastatin Every Other Day Compared with Once Daily in Patients with Hypercholesterolemia

Assistant Professor, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand

Nakarin Sansanayudh, MD

Lieutenant Colonel, Department of Cardiology, Phramongkutklao Hospital, Bangkok

Rawadee Dhummauppakorn, MEng

Associate Professor, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University

Chutiporn Kitiyadisai, MSc

Clinical Pharmacist, Department of Pharmacy, Prapinklao Hospital, Bangkok

Reprints: Dr. Wongwiwatthananukit, Department of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok 10330, Thailand, fax 662/218-8403, supakit.w{at}chula.ac.th

BACKGROUND: Although most patients with hypercholesterolemia require life-long therapy with statins, these drugs are underused due to high costs. Every-other-day therapy could be one strategy to resolve this problem.

OBJECTIVE: To compare the efficacy and safety of rosuvastatin 10 mg administered every other day versus once daily.

METHODS: An 8 week, randomized, open-label, parallel trial was conducted at the outpatient department of Phramongkutklao Hospital in Bangkok, Thailand. Eighty patients with primary hypercholesterolemia were equally randomized to receive rosuvastatin 10 mg once daily or every other day; 76 patients completed the study. Laboratory data were assessed at baseline and at the end of the study.

RESULTS: Low-density lipoprotein cholesterol (LDL-C) levels were reduced by 48% and 39% in the once-daily and every-other-day groups, respectively (p = 0.011). The percentage of patients who achieved LDL-C goals according to National Cholesterol Education Program-Adult Treatment Panel III guidelines was not significantly different between the once-daily (85%) and every-other-day (70%) groups (p = 0.180). In addition, both regimens were well tolerated, with no patient developing an elevation of more than 3 times baseline levels of aspartate aminotransferase or alanine aminotransferase or 10 times that of creatine kinase. As expected, the monthly cost per percent LDL-C reduction of the once-daily ($0.72) regimen was about 38% higher than that of the every-other-day ($0.44) regimen.

CONCLUSIONS: Every-other-day dosing of rosuvastatin may be an alternative regimen for cost savings, without a major decrease in therapeutic benefit or increase in adverse events, in patients with hypercholesterolemia. The number of patients achieving their LDL-C goal using the every-other-day regimen is comparable with the number using the once-daily regimen, especially in the low-risk patient category.

Key Words: dosing, rosuvastatin

Published Online, September 26, 2006. www.theannals.com, DOI 10.1345/aph.1H124

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