Rosuvastatin: A high-potency HMG-CoA reductase inhibitor

Objective: To summarize the relevant pharmacologic, clinical, and safety data regarding rosuvastatin (Crestor-AstraZeneca), the most recently marketed 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor approved for the treatment of dyslipidemia. Data Sources: Medline search from years 1990 thru 2005 using the keywords HMG-CoA reductase inhibitor, hypercholesterolemia, lipid-lowering agents, rosuvastatin, and statins. Study Selection: Review articles, clinical trials, case reports, abstracts, and data on file from the manufacturer concerning rosuvastatin and other statins were considered for inclusion. Data Extraction: English-language studies were selected for inclusion. Data Synthesis: Multiple clinical trials have revealed that use of rosuvastatin is associated with greater reductions in low-density lipoprotein cholesterol (LDL-C) across the dose range of 5-40 mg/day than any other currently available statins. Rosuvastatin also significantly increases high-density lipoprotein cholesterol and reduces triglycerides significantly as well. In clinical trials, rosuvastatin was well tolerated, with a low incidence of adverse events and a safety profile similar to that of the other marketed statins. At present, no largescale primary or secondary prevention clinical trials document either long-term safety of rosuvastatin or its effectiveness in preventing coronary events. Conclusion: Compared with other statins, rosuvastatin offers the greatest lipid-lowering efficacy at the lowest dose in treating patients with dyslipidemia and with a similar safety profile over the short-term. Rosuvastatin may allow more patients to achieve their LDL-C goals than any other statin and at a lower dose than other agents.