Which one is better statin and why (Part 1)
STATIN SELECTION
A. Dosage & Administration
At the start dose and following dose titration, rosuvastatin was significantly more effective than atorvastatin at reducing LDL-C and achieving European LDL-C goals in patients with type 2 diabetes.
Key Notes
The results obtained in the current study have shown that rosuvastatin is the most effective statin at reducing LDL-C, triglycerides, and total cholesterol, at the lowest dose (10 mg). Moreover, it reduced HDL-C the least in comparison to the other statins.
Rosuvastatin VS Atorvastatin
Rosuvastatin was more efficacious than the same dose of atorvastatin (1:1 dose ratio) or a 2 times higher dose (1:2 dose ratio) of atorvastatin.
There was no significant difference between rosuvastatin and a 4 times higher dose of atorvastatin (1:4 dose ratio).
There were no significant differences between rosuvastatin and atorvastatin at any dose ratio for adverse events.
B. Potency
Rosuvastatin and Atorvastain are the most potent statins with respect to lowering LDL, followed by simvastatin and pravastatin.
Atorvastatin, lovastatin, and simvastatin are *lipophilic, whereas pravastatin, rosuvastatin, and fluvastatin are more **hydrophilic.
*Lipophilic statins cross the blood-brain barrier more readily, which may lead to central nervous system complaints such as insomnia, although this is rare.
**Hydrophilic statins exhibit greater hepato selectivity and less influence on smooth muscle proliferation.
References:
2018 ACC/AHA Guideline on the Treatment of Blood Cholesterol
ISRN Pharmacology: Volume 2013, Article ID 146579, 7 pages
UMHS Lipid Therapy Guideline, May 2014
Cardiovascular Diabetol. 2005; 4: 7. Published online 2005 Jun 3. doi: 10.1186/1475-2840-4-7
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