How much does rosuvastatin lower Low-Density Lipoprotein (LDL) cholesterol?

From the Guidelines

Rosuvastatin significantly lowers low-density lipoprotein (LDL) cholesterol levels by approximately 39-45% at doses of 5-10mg daily 1.

Key Points

• At a dose of 10mg daily, rosuvastatin reduces LDL levels by approximately 45% over a 6-8 week treatment period 1.
• Higher doses of 20-40mg daily have been associated with even greater reductions in LDL, ranging from 50-65%, after 12 weeks of therapy 1.
• The LDL-C lowering effect of rosuvastatin can vary depending on the individual and the specific dose used, with high-intensity statin therapy typically lowering LDL-C levels by ≥50% 1.
• Rosuvastatin is a high-intensity statin that can be used to achieve significant reductions in LDL-C levels, with 20mg and 40mg daily doses being considered high-intensity 1.

Dosage and Efficacy

• The 5-10mg daily dose of rosuvastatin is considered moderate-intensity and can lower LDL-C levels by 30-49% 1.
• The LDL-C lowering effect of rosuvastatin is dose-dependent, with higher doses resulting in greater reductions in LDL-C levels 1.

From the FDA Drug Label

Rosuvastatin-46 2-52 3-55 4--- Atorvastatin-37-43-48-51 Simvastatin-28-35-39-46 Pravastatin-20-24-30--- Table 12: LDL-C Percent Change from Baseline Rosuvastatin (n=435) LS Mean 1(95%CI) Week 6 20 mg -47% (-49%, -46%) Week 12 40 mg -55% (-57%, -54%) Table 13: Lipid-Modifying Effects of Rosuvastatin in Pediatric Patients 10 to 17 years of Age with HeFH Dose (mg) N LDL-C 5 42 -38% 10 44 -45% 20 44 -50% Table 14: Lipid-modifying Effects of Rosuvastatin in Pediatric Patients 7 to 15 years of Age with HoFH Rosuvastatin 20 mg (N=13) Percent difference (95% CI) LDL-C -22.3% (-33.5, -9.1)

Rosuvastatin lowers Low-Density Lipoprotein (LDL) cholesterol by:

• 46% at a dose of 10 mg
• 52% at a dose of 20 mg
• 55% at a dose of 40 mg
• 22.3% at a dose of 20 mg in pediatric patients with HoFH 2

From the Research

Reduction in Low-Density Lipoprotein (LDL) Cholesterol

• Rosuvastatin has been shown to lower LDL cholesterol by 45-63% at daily doses of 5-40 mg, which is statistically greater than the reductions achieved with equivalent doses of atorvastatin, simvastatin, and pravastatin 3.
• In patients with hypercholesterolemia, rosuvastatin 10-40 mg has been shown to reduce LDL-C levels by 52-63% 4.
• A study found that rosuvastatin produced dose-dependent reductions in LDL cholesterol, with decreases ranging from 34% (1 mg) to 65% (80 mg) 5.
• Rosuvastatin 40 mg reduced LDL cholesterol from baseline by 52% at 48 weeks and by 54% at 96 weeks in patients with severe hypercholesterolemia 6.

Dose-Dependent Effects

• Linear regression analysis indicated an additional 4.5% LDL cholesterol reduction for each doubling of the rosuvastatin dose 5.
• Across the dose range, approximately 90% of LDL cholesterol reduction occurred within the first 2 weeks of treatment 5.
• Dose-ranging studies in hypercholesterolemic patients demonstrated dose-dependent effects in reducing LDL-C (up to 63%) across a 1- to 40-mg dose range 7.

Comparison with Other Statins

• Rosuvastatin has been shown to be superior to atorvastatin, simvastatin, and pravastatin in reducing LDL-C and favorably modifying other components of the atherogenic lipid profile 3, 4, 7.
• Rosuvastatin produced a significant 8.4% additional reduction in LDL-C, compared with atorvastatin, across the dose ranges of the two agents 7.