W16-O-003 Efficacy and safety of rosuvastatin 40 MG in patients with severe type IIA and IIB hypercholesterolaemia

The safety of rosuvastatin: effects on renal and hepatic function

Statins, or 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, have been shown to reduce elevated serum cholesterol resulting in a reduced risk of coronary artery disease and its complications. Rosuvastatin is the latest of the class of HMG-CoA reductase inhibitors and has the most potent reduction of low-density lipoprotein and elevation of high-density lipoprotein in the class. Questions have been raised about its safety. In a careful examination of the data, rosuvastatin has the same rate of elevations of hepatic enzymes as the other statins. Whether any of the statins actually cause significant liver injury is doubtful, and this raises questions about the usefulness of routine monitoring of liver enzymes in statin patients. Rosuvastatin has been noted to produce low levels of transient proteinuria. However, transient proteinuria is seen with other comparable statins. Long-term administration of rosuvastatin and other statins have been shown not to be associated with any decline in renal function, but instead have been shown to produce modest but clear improvement in glomerular filtration rate. Therefore, it is clear that rosuvastatin, and other statins, are very safe and useful agents and do not appear to present significant risks to hepatic or renal safety.

A triumvirate of targets in the prevention and treatment paradigm for cardiovascular disease

Statins have revolutionized the management of cardiovascular disease (CVD). Reductions in low-density lipoprotein cholesterol (LDL-C) with statin therapy have been shown to reduce significantly the risk of CVD in primary and secondary prevention trials. Recent evidence from clinical trials supports the concept that lower LDL-C levels, below current guideline targets, provide additional protection against cardiovascular (CV) events. In addition evidence is accumulating that increasing high-density lipoprotein cholesterol (HDL-C) and decreasing the level of chronic inflammation are important targets in CVD risk reduction. Recent studies have investigated the effectiveness of statins in terms of their ability to concomitantly reduce LDL-C, increase HDL-C and lower C-reactive protein (CRP). Results demonstrate that the more effective statins have beneficial effects on this triumvirate of potential treatment targets. Furthermore, the overall safety and tolerability profile is comparable among available statins. This paper examines recent data highlighting the role that statins and other lipid-lowering agents can play in this new treatment paradigm.