Journal List > J Lipid Atheroscler > v.5(1) > 1059580

Suh, Jung, Hong, Kim, Song, Sohn, and Choi: Economic Evaluation of Rosuvastatin and Atorvastatin for the Treatment of Dyslipidemia from a Korean Health System Perspective

Abstract

Objective

This study aims to analyze cost-effectiveness of two most-commonly used statins from the perspective of the Korean national health system.

Methods

The scope of the analysis included rosuvastatin (5 mg, 10 mg, and 20 mg) and atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Effectiveness was defined as percentage (%) and absolute (mg/dL) reductions of low-density lipoprotein cholesterol (LDL-C) from the baseline. They were derived from published randomized controlled studies for rosuvastatin and atorvastatin. Effectiveness was defined as reductions in LDL-C levels per mg dose of the drugs. The annual direct medical costs including drug acquisition costs and monitoring costs over the one-year time horizon were calculated for each alternative. The average cost-effectiveness ratios (ACERs) and incremental cost-effectiveness ratios (ICERs) for each statin dose were calculated.

Results

The ACERs for all doses of rosuvastatin (5 mg, 10 mg, and 20 mg) were lower than those for all doses of atorvastatin (10 mg, 20 mg, 40 mg, and 80 mg). Rosuvastatin 10 mg was the most cost-effective statin for LDL-C reduction. In cost-effectiveness analyses for corresponding doses of rosuvastatin and atorvastatin, rosuvastatin was the superior strategy which suggests both higher effectiveness and lower costs than atorvastatin. However, we have to consider this analysis is highly influenced by current price of statins in each market.

Conclusions

For reduction of LDL-C levels in Korean patients with dyslipidemia, rosuvastatin 10mg is the most cost-effective statin in the current Korean market.

Figures and Tables

Fig. 1

Average cost-effectiveness ratio by Reduction of LDL-C reduction (mg/dL) from baseline in atorvastatin and rosuvastatin, R; rosuvastatin, A; atorvastatin, LDL-C; low-density lipoprotein cholesterol, ACER; average cost-effectiveness ratio, cost per LDL-C reduction (mg/dL)

jla-5-61-g001
Table 1
Effectiveness of each comparator
jla-5-61-i001
Dose Country Comparators Reduction of LDL-C from baseline (%) Reduction of LDC-C from baseline (mg/dL) Number of Studies
Individual dose All R2.5 40.93 65.19 2
R5 35.97 58.57 7
R10 45.17 76.58 35
R20 48.00 78.30 13
R40 54.77 83.21 11
R80 53.29 117.84 3
A5 37.39 43.00 1
A10 36.50 61.51 27
A20 43.63 71.63 22
A40 43.06 77.59 5
A80 45.57 68.37 16
R2.5 40.93 65.19 2
R5 34.05 52.00 4
R10 47.88 75.35 5
Asian R20 49.18 60.00 1
A5 37.39 43.00 1
A10 34.02 53.82 9
A20 49.09 54.00 1
A40 40.17 47.00 1
Equivalent dose All R5 vs. A10 35.97 vs. 32.39 58.57 vs. 52.83 7
R10 vs. A20 45.42 vs. 45.42 75.48 vs. 71.46 16
R20 vs. A40 43.93 vs. 43.06 78.28 vs. 77.59 5
R20 vs. A80 43.93 vs. 45.54 57.55 vs. 59.40 2
Asian R5 vs. A10 34.05 vs. 31.04 52.00 vs. 47.67 4
R10 vs. A20 51.38 vs. 49.09 56.00 vs. 54.00 1*
R20 vs. A40 49.18 vs. 40.17 60.00 vs. 47.00 1*

LDL-C; low-density lipoprotein cholesterol A5, A10, A20, A40, A80 stand for atorvastatin 5 mg, 10 mg, 20 mg, 40 mg, 80 mg, respectively; R2.5, R5, R10, R10, R20, R40 stand for rosuvastatin 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg, respectively;

*Study performed in Republic of Korea.

Table 2
Annual cost of monitoring and cost-effectiveness ratio of statin medication
jla-5-61-i002
Comparators Daily cost (won) Annual cost (won) Reduction of LDC-C from baseline ACER
Drug Monitoring Total % mg/dL Won/% Won/mg/dL
R 5 346 126,290 206,836 333,126 35.97 58.57 9,261 5,688
R 10 612 223,380 206,836 430,216 45.17 76.58 9,524 5,618
R 20 686 250,390 206,836 457,226 48.00 78.30 9,526 5,839
A 10 663 241,995 206,836 448,831 36.50 61.51 12,297 7,297
A 20 712 259,880 206,836 466,716 43.63 71.63 10,697 6,516
A 40 1,391 507,715 206,836 714,551 43.06 77.59 16,594 9,209
A 80 1,591 580,715 206,836 787,551 45.57 68.37 17,282 11,519

LDL-C; low-density lipoprotein cholesterol, ACER; average cost-effectiveness ratio, cost per LDL-C reduction (mg/dL); A5, A10, A20, A40, A80 stand for Atorvastatin 5 mg, 10 mg, 20 mg, 40 mg, 80 mg, respectively; R2.5, R5, R10, R10, R20, R40 stand for Rosuvastatin 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg, respectively.

Table 3
Annual cost of monitoring and cost-effectiveness ratio of statin medication in Asian studies
jla-5-61-i003
Comparators Daily cost (won) Annual cost (won) Reduction of LDC-C from baseline ACER
Drug Monitoring Total % mg/dL Won/% Won/mg/dL
R 5 346 126,290 206,836 333,126 34.05 52.00 9,783 6,406
R 10 612 223,380 206,836 430,216 47.88 75.35 8,985 5,710
R 20 686 250,390 206,836 457,226 49.18 60.00 9,297 7,620
A 10 663 241,995 206,836 448,831 34.02 53.82 13,193 8,339
A 20 712 259,880 206,836 466,716 49.09 54.00 9,507 8,643
A 40 1,391 507,715 206,836 714,551 40.17 47.00 17,788 15,203

LDL-C; low-density lipoprotein cholesterol, ACER: average cost-effectiveness ratio, cost per LDL-C reduction (mg/dL); A5, A10, A20, A40, A80 stand for Atorvastatin 5 mg, 10 mg, 20 mg, 40 mg, respectively; R2.5, R5, R10, R10, R20, R40 stand for Rosuvastatin 2.5 mg, 5 mg, 10 mg, 20 mg, 40 mg, respectively.

Table 4
Incremental cost-effectiveness ratios
jla-5-61-i004
Comparators Annual cost (won) Difference of Reduction of LDC-C from baseline (R-A) ICER (%) ICER (mg/dL)
Difference (R-A) % md/dL
R 5 vs. A10 -113,347 3.58 5.74 R is dominant R is dominant
R 10 vs. A20 -37,153 1.97 4.02 R is dominant R is dominant
R 20 vs. A40 -240,594 0.87 0.69 R is dominant R is dominant
R20 vs. A80 -324,204 -1.61 -1.85 201,369* 175,245*

LDL-C; low-density lipoprotein cholesterol, ICER; incremental cost-effectiveness ratio, additional cost per additional LDL-C reduction; R5, R10, R10, R20 stand for Rosuvastatin 5 mg, 10 mg, 20 mg, respectively; A10, A20, A40, A80 stand for Atorvastatin 10 mg, 20 mg, 40 mg, 80 mg, respectively. *ICER for atorvastatin 80 mg compared to rosuvastatin 20 mg

References

1. GBD 2013 Mortality and Causes of Death Collaborators. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015; 385:117–171.
2. Lim D, Ha M, Song I. Trends in the leading causes of death in Korea, 1983-2012. J Korean Med Sci. 2014; 29:1597–1603.
crossref
3. Cholesterol Treatment Trialists' (CTT) Collaborators. Mihaylova B, Emberson J, Blackwell L, Keech A, Simes J, et al. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012; 380:581–590.
crossref
4. Franco OH, Peeters A, Looman CW, Bonneux L. Cost effectiveness of statins in coronary heart disease. J Epidemiol Community Health. 2005; 59:927–933.
crossref
5. Ward S, Lloyd Jones M, Pandor A, Holmes M, Ara R, Ryan A, et al. A systematic review and economic evaluation of statins for the prevention of coronary events. Health Technol Assess. 2007; 11:1–160. iii–iv.
crossref
6. Stone NJ, Robinson JG, Lichtenstein AH, Bairey Merz CN, Blum CB, Eckel RH, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2014; 129:S1–S45.
7. Pencina MJ, Navar-Boggan AM, D'Agostino RB Sr, Williams K, Neely B, Sniderman AD, et al. Application of new cholesterol guidelines to a population-based sample. N Engl J Med. 2014; 370:1422–1431.
crossref
8. IMS Health Korea 2015. Available from: http://www.imshealth.com/ko_KR/.
9. Kang HY, Ko SK, Liew D. Results of a Markov model analysis to assess the cost-effectiveness of statin therapy for the primary prevention of cardiovascular disease in Korea: the Korean individual-microsimulation model for cardiovascular health interventions. Clin Ther. 2009; 31:2919–2930.
crossref
10. Han KH, Kim HJ, Kim JJ. Cost-effectiveness of the use of statins in the Korean population. J Lipid Atheroscler. 2012; 1:87–94.
crossref
11. Bellosta S, Paoletti R, Corsini A. Safety of statins: focus on clinical pharmacokinetics and drug interactions. Circulation. 2004; 109:III50–III57.
12. Saku K, Zhang B, Noda K. PATROL Trial Investigators. Randomized head-to-head comparison of pitavastatin, atorvastatin, and rosuvastatin for safety and efficacy (quantity and quality of LDL): the PATROL trial. Circ J. 2011; 75:1493–1505.
crossref
13. Miller PS, Smith DG, Jones P. Cost effectiveness of rosuvastatin in treating patients to low-density lipoprotein cholesterol goals compared with atorvastatin, pravastatin, and simvastatin (a US Analysis of the STELLAR Trial). Am J Cardiol. 2005; 95:1314–1319.
crossref
14. Health Insurance Review & Assessment Service (KR). National drug formulary list (2013.01.01-2015.11.01). [Internet]. Wonju: Health Insurance Review & Assessment Service;Accessed Oct 28, 2015. Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA030014050000.
15. Health Insurance Review & Assessment Service (KR). Reimbursement price list for healthcare services (Sep/Oct 2015). [Internet]. Wonju: Health Insurance Review & Assessment Service;Accessed Aug 28, 2015. Available from: http://www.hira.or.kr/dummy.do?pgmid=HIRAA020002000000&cmsurl=/cms/inform/01/1336549_27106.html&subject.
16. Health Insurance Review & Assessment Service (KR). Healthcare utilization statistical information. [Internet]. Wonju: Health Insurance Review & Assessment Service;Accessed Aug 28, 2015. Available from: http://www.hira.or.kr/rd/dissdic/infoSickList.do?sickType=1&pgmid=HIRAA020044020100.
17. Jee SH, Batty GD, Jang Y, Oh DJ, Oh BH, Lee SH, et al. The Korean Heart Study: rationale, objectives, protocol, and preliminary results for a new prospective cohort study of 430,920 men and women. Eur J Prev Cardiol. 2014; 21:1484–1492.
crossref
18. Roh E, Ko SH, Kwon HS, Kim NH, Kim JH, Kim CS, et al. Prevalence and management of dyslipidemia in Korea: Korea National Health and Nutrition Examination Survey during 1998 to 2010. Diabetes Metab J. 2013; 37:433–449.
crossref
19. Conly J, Clement F, Tonelli M, Hemmelgarn B, Klarenbach S, Lloyd A, et al. Cost-effectiveness of the use of low-and high-potency statins in people at low cardiovascular risk. CMAJ. 2011; 183:E1180–E1188.
20. Nicholls SJ, Brandrup-Wognsen G, Palmer M, Barter PJ. Meta-analysis of comparative efficacy of increasing dose of atorvastatin versus rosuvastatin versus simvastatin on lowering levels of atherogenic lipids (from VOYAGER). Am J Cardiol. 2010; 105:69–76.
crossref
21. Lee E, Ryan S, Birmingham B, Zalikowski J, March R, Ambrose H, et al. Rosuvastatin pharmacokinetics and pharmacogenetics in white and Asian subjects residing in the same environment. Clin Pharmacol Ther. 2005; 78:330–341.
crossref
22. Hirsch M, O'Donnell J, Olsson A. Rosuvastatin is costeffective compared with atorvastatin in reaching cholesterol goals. Int J Cardiol. 2005; 104:251–256.
crossref
23. Costa-Scharplatz M, Ramanathan K, Frial T, Beamer B, Gandhi S. Cost-effectiveness analysis of rosuvastatin versus atorvastatin, simvastatin, and pravastatin from a Canadian health system perspective. Clin Ther. 2008; 30:1345–1357.
crossref
24. National Clinical Guideline Centre (GB). Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. London: National Clinical Guideline Centre;2014.
25. Jones PH, Davidson MH, Stein EA, Bays HE, McKenney JM, Miller E, et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol. 2003; 92:152–160.
crossref
26. Olsson AG, Istad H, Luurila O, Ose L, Stender S, Tuomilehto J, et al. Effects of rosuvastatin and atorvastatin compared over 52 weeks of treatment in patients with hypercholesterolemia. Am Heart J. 2002; 144:1044–1051.
crossref
27. Blasetto JW, Stein EA, Brown WV, Chitra R, Raza A. Efficacy of rosuvastatin compared with other statins at selected starting doses in hypercholesterolemic patients and in special population groups. Am J Cardiol. 2003; 91:3C–10C.
crossref
28. Yusuf S, Bosch J, Dagenais G, Zhu J, Xavier D, Liu L, et al. Cholesterol lowering in intermediate-risk persons without cardiovascular disease. N Engl J Med. 2016; 374:2021–2031.
crossref
29. Durrington P. The human and economic costs of undertreatment with statins. Int J Clin Pract. 2002; 56:357–368.
30. Law MR, Wald NJ, Thompson SG. By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? BMJ. 1994; 308:367–372.
crossref
31. Adsule SM, Baig MS, Gade PR, Khandelwal PN. A comparative evaluation of safety and efficacy of rosuvastatin, simvastatin, and atorvastatin in patients of type 2 diabetes mellitus with dyslipidemia. Int J Diabetes Dev Ctries. 2009; 29:74–79.
crossref
32. Berne C, Siewert-Delle A. URANUS study investigators. Comparison of rosuvastatin and atorvastatin for lipid lowering in patients with type 2 diabetes mellitus: results from the URANUS study. Cardiovasc Diabetol. 2005; 4:7.
crossref
33. Binbrek AS, Elis A, Al-Zaibag M, Eha J, Keber I, Cuevas AM, et al. Rosuvastatin versus atorvastatin in achieving lipid goals in patients at high risk for cardiovascular disease in clinical practice: a randomized, open-label, parallel-group, multicenter study (DISCOVERY Alpha study). Curr Ther Res Clin Exp. 2006; 67:21–43.
crossref
34. Chitose T, Sugiyama S, Sakamoto K, Shimomura H, Yamashita T, Hokamaki J, et al. Effect of a hydrophilic and a hydrophobic statin on cardiac salvage after STelevated acute myocardial infarction - a pilot study. Atherosclerosis. 2014; 237:251–258.
crossref
Danchin N., Chadarevian R., Gayet JL., Licour M., Valensi P. Compared with atorvastatin at the dose of 10 mg per day rosuvastatin was more effective to reach an LDL goal of <1.00 g/l in high cardiovascular risk patients. Ann Cardiol Angeiol (Paris). 2007. 56:82–87.
crossref
36. Davidson M, Ma P, Stein EA, Gotto AM Jr, Raza A, Chitra R, et al. Comparison of effects on low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with rosuvastatin versus atorvastatin in patients with type IIa or IIb hypercholesterolemia. Am J Cardiol. 2002; 89:268–275.
crossref
37. Deedwania PC, Gupta M, Stein M, Ycas J, Gold A;. Comparison of rosuvastatin versus atorvastatin in South-Asian patients at risk of coronary heart disease (from the IRIS Trial). Am J Cardiol. 2007; 99:1538–1543.
crossref
38. Ferdinand KC, Clark LT, Watson KE, Neal RC, Brown CD, Kong BW, et al. Comparison of efficacy and safety of rosuvastatin versus atorvastatin in African-American patients in a six-week trial. Am J Cardiol. 2006; 97:229–235.
crossref
39. Fonseca FA, Ruiz A, Cardona-Muñoz EG, Silva JM, Fuenmayor N, Marotti M;. The DISCOVERY PENTA study: a direct statin comparison of LDL-C value--an evaluation of rosuvastatin therapY compared with atorvastatin. Curr Med Res Opin. 2005; 21:1307–1315.
crossref
40. Herregods MC, Daubresse JC, Michel G, Lamotte M, Vissers E, Vandenhoven G. Discovery Belux. Discovery Belux: comparison of rosuvastatin with atorvastatin in hypercholesterolaemia. Acta Cardiol. 2008; 63:493–499.
crossref
41. Kurabayashi M, Yamazaki T. SUBARU Study Group. Superior benefit of aggressive lipid-lowering therapy for high- risk patients using statins: the SUBARU study--more hypercholesterolemic patients achieve Japan Atherosclerosis Society LDL-C goals with rosuvastatin therapy than with atorvastatin therapy. J Atheroscler Thromb. 2008; 15:314–323.
crossref
42. Ogawa H, Matsui K, Saito Y, Sugiyama S, Jinnouchi H, Sugawara M, et al. Differences between rosuvastatin and atorvastatin in lipid-lowering action and effect on glucose metabolism in Japanese hypercholesterolemic patients with concurrent diabetes. Lipid-lowering with highly potent statins in hyperlipidemia with type 2 diabetes patients (LISTEN) study –. Circ J. 2014; 78:2512–2515.
crossref
43. Olsson AG, Pears J, McKellar J, Mizan J, Raza A. Effect of rosuvastatin on low-density lipoprotein cholesterol in patients with hypercholesterolemia. Am J Cardiol. 2001; 88:504–508.
crossref
44. Park JS, Kim YJ, Choi JY, Kim YN, Hong TJ, Kim DS, et al. Comparative study of low doses of rosuvastatin and atorvastatin on lipid and glycemic control in patients with metabolic syndrome and hypercholesterolemia. Korean J Intern Med. 2010; 25:27–35.
crossref
45. Qu HY, Xiao YW, Jiang GH, Wang ZY, Zhang Y, Zhang M. Effect of atorvastatin versus rosuvastatin on levels of serum lipids, inflammatory markers and adiponectin in patients with hypercholesterolemia. Pharm Res. 2009; 26:958–964.
crossref
46. Rosenson RS, Otvos JD, Hsia J. Effects of rosuvastatin and atorvastatin on LDL and HDL particle concentrations in patients with metabolic syndrome: a randomized, double-blind, controlled study. Diabetes Care. 2009; 32:1087–1091.
crossref
47. Schneck DW, Knopp RH, Ballantyne CM, McPherson R, Chitra RR, Simonson SG. Comparative effects of rosuvastatin and atorvastatin across their dose ranges in patients with hypercholesterolemia and without active arterial disease. Am J Cardiol. 2003; 91:33–41.
crossref
48. Schuster H, Barter PJ, Stender S, Cheung RC, Bonnet J, Morrell JM, et al. Effects of switching statins on achievement of lipid goals: measuring effective reductions in cholesterol using rosuvastatin therapy (MERCURY I) study. Am Heart J. 2004; 147:705–713.
crossref
49. Schwartz GG, Bolognese MA, Tremblay BP, Caplan R, Hutchinson H, Raza A, et al. Efficacy and safety of rosuvastatin and atorvastatin in patients with hypercholesterolemia and a high risk of coronary heart disease: a randomized, controlled trial. Am Heart J. 2004; 148:e4.
crossref
50. Stalenhoef AF, Ballantyne CM, Sarti C, Murin J, Tonstad S, Rose H, et al. A comparative study with rosuvastatin in subjects with metabolic syndrome: results of the COMETS study. Eur Heart J. 2005; 26:2664–2672.
crossref
51. Strandberg TE, Feely J, Sigurdsson EL. DISCOVERY study group. Twelve-week, multicenter, randomized, openlabel comparison of the effects of rosuvastatin 10 mg/d and atorvastatin 10 mg/d in high-risk adults: a DISCOVERY study. Clin Ther. 2004; 26:1821–1833.
crossref
52. Yamazaki T, Kurabayashi M. ASTRO-1 Study Group. A randomized controlled study to compare the effects of rosuvastatin 5 mg and atorvastatin 10 mg on the plasma lipid profile in Japanese patients with hypercholesterolemia (ASTRO-2). Ann Vasc Dis. 2009; 2:159–173.
crossref
53. Zhu JR, Tomlinson B, Ro YM, Sim KH, Lee YT, Sriratanasathavorn C. A randomised study comparing the efficacy and safety of rosuvastatin with atorvastatin for achieving lipid goals in clinical practice in Asian patients at high risk of cardiovascular disease (DISCOVERY-Asia study). Curr Med Res Opin. 2007; 23:3055–3068.
crossref
54. Anagnostis P, Adamidou F, Slavakis A, Polyzos SA, Selalmatzidou D, Panagiotou A, et al. Comparative effect of atorvastatin and rosuvastatin on 25-hydroxyvitamin D levels in non-diabetic patients with dyslipidaemia: a prospective randomized open-label pilot study. Open Cardiovasc Med J. 2014; 8:55–60.
crossref
55. Arshad AR. Comparison of low-dose rosuvastatin with atorvastatin in lipid-lowering efficacy and safety in a high-risk pakistani cohort: an open-label randomized trial. J Lipids. 2014; 2014:875907.
crossref
56. Bahadir MA, Oguz A, Uzunlulu M, Bahadir O. Effects of different statin treatments on small dense low-density lipoprotein in patients with metabolic syndrome. J Atheroscler Thromb. 2009; 16:684–690.
crossref
57. Ballantyne CM, Bertolami M, Hernandez Garcia HR, Nul D, Stein EA, Theroux P, et al. Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: measuring effective reductions in cholesterol using rosuvastatin therapY (MERCURY) II. Am Heart J. 2006; 151:975.e1–975.e9.
crossref
58. Betteridge DJ, Gibson JM, Sager PT. Comparison of effectiveness of rosuvastatin versus atorvastatin on the achievement of combined C-reactive protein (<2 mg/L) and low-density lipoprotein cholesterol (<70 mg/dl) targets in patients with type 2 diabetes mellitus (from the ANDROMEDA study). Am J Cardiol. 2007; 100:1245–1248.
crossref
59. Clearfield MB, Amerena J, Bassand JP, Hernández García HR, Miller SS, Sosef FF, et al. Comparison of the efficacy and safety of rosuvastatin 10 mg and atorvastatin 20 mg in high-risk patients with hypercholesterolemia--prospective study to evaluate the use of low doses of the statins atorvastatin and rosuvastatin (PULSAR). Trials. 2006; 7:35.
60. Koksal M, Eren MA, Turan MN, Sabuncu T. The effects of atorvastatin and rosuvastatin on oxidative stress in diabetic patients. Eur J Intern Med. 2011; 22:249–253.
crossref
61. Lee CW, Kang SJ, Ahn JM, Song HG, Lee JY, Kim WJ, et al. Comparison of effects of atorvastatin (20 mg) versus rosuvastatin (10 mg) therapy on mild coronary atherosclerotic plaques (from the ARTMAP trial). Am J Cardiol. 2012; 109:1700–1704.
crossref
62. Mazza F, Stefanutti C, Di Giacomo S, Vivenzio A, Fraone N, Mazzarella B, et al. Effects of low-dose atorvastatin and rosuvastatin on plasma lipid profiles: a long-term, randomized, open-label study in patients with primary hypercholesterolemia. Am J Cardiovasc Drugs. 2008; 8:265–270.
crossref
63. Milionis HJ, Rizos E, Kostapanos M, Filippatos TD, Gazi IF, Ganotakis ES, et al. Treating to target patients with primary hyperlipidaemia: comparison of the effects of ATOrvastatin and ROSuvastatin (the ATOROS study). Curr Med Res Opin. 2006; 22:1123–1131.
crossref
64. Namal E, Sener N, Ulaş T, Akçalı Z, Oztekin E, Borlu F. Effects of different statins, ezetimibe/simvastatin combination on hsCRP levels in unstable angina pectoris and non-ST elevation myocardial infarction patients: a randomized trial. Anadolu Kardiyol Derg. 2011; 11:703–710.
crossref
65. Puccetti L, Santilli F, Pasqui AL, Lattanzio S, Liani R, Ciani F, et al. Effects of atorvastatin and rosuvastatin on thromboxane-dependent platelet activation and oxidative stress in hypercholesterolemia. Atherosclerosis. 2011; 214:122–128.
crossref
66. Bays HE, Averna M, Majul C, Muller-Wieland D, De Pellegrin A, Giezek H, et al. Efficacy and safety of ezetimibe added to atorvastatin versus atorvastatin uptitration or switching to rosuvastatin in patients with primary hypercholesterolemia. Am J Cardiol. 2013; 112:1885–1895.
crossref
67. Hong YJ, Jeong MH, Hachinohe D, Ahmed K, Choi YH, Cho SH, et al. Comparison of effects of rosuvastatin and atorvastatin on plaque regression in Korean patients with untreated intermediate coronary stenosis. Circ J. 2011; 75:398–406.
crossref
68. Kurtoglu E, Balta S, Sincer I, Altas Y, Atas H, Yilmaz M, et al. Comparision of effects of rosuvastatin versus atorvastatin treatment on plasma levels of asymmetric dimethylarginine in patients with hyperlipidemia having coronary artery disease. Angiology. 2014; 65:788–793.
crossref
69. Leiter LA, Rosenson RS, Stein E, Reckless JP, Schulte KL, Schleman M, et al. Efficacy and safety of rosuvastatin 40 mg versus atorvastatin 80 mg in high-risk patients with hypercholesterolemia: results of the POLARIS study. Atherosclerosis. 2007; 194:e154–e164.
70. Tsutamoto T, Sakai H, Ibe K, Yamaji M, Kawahara C, Nakae I, et al. Effect of atorvastatin vs. rosuvastatin on cardiac sympathetic nerve activity in non-diabetic patients with dilated cardiomyopathy. Circ J. 2011; 75:2160–2166.
crossref
71. Ai M, Otokozawa S, Asztalos BF, Nakajima K, Stein E, Jones PH, et al. Effects of maximal doses of atorvastatin versus rosuvastatin on small dense low-density lipoprotein cholesterol levels. Am J Cardiol. 2008; 101:315–318.
crossref
72. Asztalos BF, Le Maulf F, Dallal GE, Stein E, Jones PH, Horvath KV, et al. Comparison of the effects of high doses of rosuvastatin versus atorvastatin on the subpopulations of high-density lipoproteins. Am J Cardiol. 2007; 99:681–685.
crossref
73. Aydin MU, Aygul N, Altunkeser BB, Unlu A, Taner A. Comparative effects of high-dose atorvastatin versus moderate-dose rosuvastatin on lipid parameters, oxidized-LDL and inflammatory markers in ST elevation myocardial infarction. Atherosclerosis. 2015; 239:439–443.
crossref
74. Bergheanu SC, Van Tol A, Dallinga-Thie GM, Liem A, Dunselman PH, Van der Bom JG, et al. Effect of rosuvastatin versus atorvastatin treatment on paraoxonase-1 activity in men with established cardiovascular disease and a low HDL-cholesterol. Curr Med Res Opin. 2007; 23:2235–2240.
crossref
75. Jukema JW, Liem AH, Dunselman PH, van der Sloot JA, Lok DJ, Zwinderman AH. LDL-C/HDL-C ratio in subjects with cardiovascular disease and a low HDL-C: results of the RADAR (rosuvastatin and atorvastatin in different dosages and reverse cholesterol transport) study. Curr Med Res Opin. 2005; 21:1865–1874.
crossref
76. Lablanche JM, Leone A, Merkely B, Morais J, Alonso J, Santini M, et al. Comparison of the efficacy of rosuvastatin versus atorvastatin in reducing apolipoprotein B/apolipoprotein A-1 ratio in patients with acute coronary syndrome: results of the CENTAURUS study. Arch Cardiovasc Dis. 2010; 103:160–169.
crossref
77. Marais AD, Raal FJ, Stein EA, Rader DJ, Blasetto J, Palmer M, et al. A dose-titration and comparative study of rosuvastatin and atorvastatin in patients with homozygous familial hypercholesterolaemia. Atherosclerosis. 2008; 197:400–406.
crossref
78. Nicholls SJ, Ballantyne CM, Barter PJ, Chapman MJ, Erbel RM, Libby P, et al. Effect of two intensive statin regimens on progression of coronary disease. N Engl J Med. 2011; 365:2078–2087.
crossref
79. Pitt B, Loscalzo J, Monyak J, Miller E, Raichlen J. Comparison of lipid-modifying efficacy of rosuvastatin versus atorvastatin in patients with acute coronary syndrome (from the LUNAR study). Am J Cardiol. 2012; 109:1239–1246.
crossref
80. van Himbergen TM, Matthan NR, Resteghini NA, Otokozawa S, Ai M, Stein EA, et al. Comparison of the effects of maximal dose atorvastatin and rosuvastatin therapy on cholesterol synthesis and absorption markers. J Lipid Res. 2009; 50:730–739.
crossref
81. Wolffenbuttel BH, Franken AA, Vincent HH. Dutch Corall Study Group. Cholesterol-lowering effects of rosuvastatin compared with atorvastatin in patients with type 2 diabetes -- CORALL study. J Intern Med. 2005; 257:531–539.
crossref

Supplementary Material

Supplementary Table 1

Studies included in meta-analysis
TOOLS
Similar articles