0300-7995 doi:10.1185/030079907X219580
Current Medical Research and Opinion® Vol. 23, No. , 2007, 2125–2133 © 2007 LibraPharm Limited
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ORIGINAL ARTICLE
Effectiveness of rosuvastatin in low-density lipoprotein cholesterol lowering and National Cholesterol Education Program Adult Treatment Panel guideline III LDL‑C goal attainment compared to other statins among diabetes mellitus patients: a retrospective study using an electronic medical records dataset in the United States Kathleen M. Fox a, Sanjay K. Gandhi b, Robert L. Ohsfeldt c, James W. Blasetto b and Harold E. Bays d University of Maryland School of Medicine, Department of Epidemiology & Preventive Medicine, Baltimore, MD, USA
a
AstraZeneca Pharmaceuticals LP, Wilmington, DE, USA
b
Texas A&M Health Science Center, Department of Health Policy & Management, College Station, TX, USA
c
Louisville Metabolic & Atherosclerosis Research Center, Louisville, KY, USA
d
Address for correspondence: Kathleen M. Fox, PhD, P.O. Box 543, Monkton, MD 21111, USA. Tel.: +1 410 343 1357; Fax: +1 410 357 8018;
[email protected] Key words: ATP III goal attainment – Clinical practice – Diabetes mellitus – LDL‑C reduction – Rosuvastatin ABSTRACT
Objective: To compare effectiveness of rosuvastatin (RSV) with other statins on lowering low-density lipoprotein cholesterol (LDL-C) and LDL‑C goal attainment among patients with type 1 or type 2 diabetes mellitus. Methods: A retrospective study using US General Electric Medical Systems (GEMS) database of patients with diabetes mellitus (ICD9 code = 250, prescription for anti-diabetic medication or
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fasting blood glucose level ≥ 126 mg/dL in the 12 months preceding statin therapy) treated across clinical practices in the US, who were newly prescribed statin therapy during August 2003 – March 2006, was conducted. Multivariate linear and logistic regression models were used for analyzing prescription data with baseline LDL-C, age, gender, smoking, very high CHD risk, systolic blood pressure, and statin duration as covariates.
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Results: Of 4754 diabetes mellitus patients, 5% were prescribed RSV, 59% atorvastatin (ATV), 21% simvastatin (SMV), 5% pravastatin (PRV), 2% fluvastatin (FLV), and 7% lovastatin (LOV). RSV patients had significantly higher ( p < 0.05) baseline mean LDL‑C levels (138 vs. 117–131 mg/dL), lower average starting dose (11.7 vs. 17.0–63.7 mg) and were younger ( p < 0.005) than patients on other statins (mean age 61 vs. 63–69 years). Percent LDL‑C reduction was significantly greater ( p < 0.0001) with RSV (28.4%) compared to ATV (22.5%), SMV (20.1%), PRV (13.7%), FLV (15.8%),
Introduction The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) identified diabetes mellitus as an atherosclerotic coronary heart disease (CHD) risk equivalent condition that places patients at high risk for CHD1. According to NCEP, the risk equivalent conditions carry a risk for major coronary events equal to that of established CHD1. Thus, it is recommended that diabetes mellitus patients achieve an LDL‑C goal of at least
