Daily and intermittent rosuvastatin 5 mg therapy in statin intolerant patients: an observational study

Objective: To examine the efficacy and tolerability of rosuvastatin 5 mg at daily and non-daily dosing regimens. Research design and methods: A retrospective survey was conducted at nine primary, secondary and tertiary healthcare centres in the United Kingdom. Main outcome measures: Changes in lipid fractions from baseline values after more than 3 months' treatment. Results: A total of 325 patients were identified. These patients were aged 63 +/- 10 years, 50% male and prescription was mostly for primary prevention of cardiovascular disease (CVD) (59%). Co-morbidities included: established CVD present in 41%, type 2 diabetes mellitus (15%), hypertension (74%) and smoking (9%). Adverse effects had been documented to simvastatin (75%) or atorvastatin (63%). A total of 289 patients (89%) tolerated rosuvastatin well and were still adherent after a median follow-up of 14.9 (3-79) months. The remainder (n = 36; 11%) discontinued the medication after median 5 months' treatment due to adverse effects. Efficacy was assessed in 224 patients who had adequate data. Baseline lipids were total cholesterol (TC) 7.41 +/- 1.50 mmol/L, triglycerides (TG) 2.26 (range 0.36-18.4) mmol/L; high density lipoprotein cholesterol (HDL-C) 1.43 +/- 0.47 mmol/L and low density lipoprotein cholesterol (LDL-C) 4.76 +/- 1.38 mmol/L. Daily rosuvastatin (n = 134) reduced mean TC by 31%, TG 15% and LDL-C 43% (p<0.001). Rosuvastatin 5 mg 2-3 times weekly (n = 79) reduced TC 26%, TG 16% and LDL-C 32% (p<0.001). Weekly rosuvastatin (n = 11) reduced TC 17%, LDL-C by 23% (p<0.001) but had no effect on TGs. Targets were attained in 17% of CHD-risk equivalent patients and 41% of primary prevention patients by National Cholesterol Education Program criteria and 27% and 68% using UK targets. No myositis or rhabdomyolysis was observed and alanine aminotransferase (ALT) and creatine kinase (CK) were similar to baseline. Conclusions: In this retrospective observational multicentre study, rosuvastatin 5 mg was found to be safe and biochemically effective either as daily or intermittent therapy in patients intolerant to other conventional statin regimens.