瑞舒伐他汀的降脂效果。
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Adams SP, Sekhon SS, Wright JM
瑞舒伐他汀的降脂效果。
Cochrane Database Syst Rev. 2014 11月21日;(11):CD010254。cd010254.pub2 doi: 10.1002/14651858.。
- PubMed ID
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25415541 (PubMed视图］
- 摘要
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背景:瑞舒伐他汀是最有效的他汀类药物之一，目前被广泛使用。因此，了解瑞舒伐他汀对血脂影响的剂量相关大小是很重要的。目的:主要目的量化不同剂量瑞舒伐他汀对有和没有心血管疾病证据的受试者血清总胆固醇、低密度脂蛋白(LDL)-胆固醇、高密度脂蛋白(HDL)-胆固醇、非HDL-胆固醇和甘油三酯的影响。次要目的:量化不同剂量瑞舒伐他汀疗效的变异性。在随机安慰剂对照试验中量化不良反应(WDAEs)引起的停药。必威国际app检索方法:我们检索了Cochrane图书馆的Cochrane中央对照试验注册中心(Central) 2014年12月第10期，MEDLINE(1946年至2014年10月第5周)，EMBASE(1980年至2014年第44周)，Web of Science核心收藏(1970年至2014年11月5日)和BIOSIS引文索引(1969年至2014年10月31日)。没有语言限制。选择标准:随机对照和不对照的前后试验，评估不同固定剂量瑞舒伐他汀对血脂的剂量反应，持续时间为3 - 12周。数据收集和分析:两篇综述作者独立评估了纳入研究的资格标准并提取了数据。WDAEs信息收集自安慰剂对照试验。 MAIN RESULTS: One-hundred and eight trials (18 placebo-controlled and 90 before-and-after) evaluated the dose-related efficacy of rosuvastatin in 19,596 participants. Rosuvastatin 10 to 40 mg/day caused LDL-cholesterol decreases of 46% to 55%, when all the trials were combined using the generic inverse variance method. The quality of evidence for these effects is high. Log dose-response data over doses of 1 to 80 mg, revealed strong linear dose-related effects on blood total cholesterol, LDL-cholesterol and non-HDL-cholesterol. When compared to atorvastatin, rosuvastatin was about three-fold more potent at reducing LDL-cholesterol. There was no dose-related effect of rosuvastatin on blood HDL-cholesterol, but overall, rosuvastatin increased HDL by 7%. There is a high risk of bias for the trials in this review, which would affect WDAEs, but unlikely to affect the lipid measurements. WDAEs were not statistically different between rosuvastatin and placebo in 10 of 18 of these short-term trials (risk ratio 0.84; 95% confidence interval 0.48 to 1.47). AUTHORS' CONCLUSIONS: The total blood total cholesterol, LDL-cholesterol and non-HDL-cholesterol-lowering effect of rosuvastatin was linearly dependent on dose. Rosuvastatin log dose-response data were linear over the commonly prescribed dose range. Based on an informal comparison with atorvastatin, this represents a three-fold greater potency. This review did not provide a good estimate of the incidence of harms associated with rosuvastatin because of the short duration of the trials and the lack of reporting of adverse effects in 44% of the placebo-controlled trials.
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