[临床医学]1-Crestor_clinic_overview.pptVIP

* * 在下列大临床对照研究中，可定?10mg均可使LDL-C降低46%左右，其降LDL-C疗效显著优于阿托伐他汀 20 mg。 * LDL-C reductions with a starting dose of different statins vary from 19% with fluvastatin to 27% with pravastatin, 28% with lovastatin, 35% with simvastatin, and 37% with atorvastatin. Doubling of a statin dose generally achieves a modest, 5%-6% incremental LDL-C reduction (“the rule of 6”). Three doublings of the atorvastatin dose (from 10 mg to 80 mg) result in LDL-C reduction 18% greater than that achieved with the starting dose (10 mg). Illingworth DR. Management of hypercholesterolemia. Med Clin North Am. 2000;84:23-42.Pravachol? prescribing information. Princeton, NJ: Bristol-Myers Squibb Company. * 冠状动脉粥样硬化是一种慢性持续进展的病变，既往的大规模他汀类药物的降脂研究（如REVERSAL研究等）证实：他汀类药物治疗可预防动脉粥样硬化的进展，稳定动脉粥样硬化病变。 ASTEROID研究是首个用确凿证据来证明强化他汀类药物治疗能逆转冠状动脉粥样硬化脂质斑块沉积的大规模临床研究，具有里程碑式的意义。 * METEOR is a randomised, double-blind, 安慰剂-controlled, parallel-group, multicentre phase III study of 瑞舒伐他汀 40 mg in the prevention of atherosclerosis among asymptomatic patients assessed as being at low risk of CHD. Patients are asymptomatic for atherosclerosis and are considered at low risk of CHD according to conventional risk factors; 10-year CHD risk is assessed using the Framingham Risk Index. 984 patients were recruited from approximately 30 US and European centres and randomised to receive 瑞舒伐他汀 or 安慰剂 in a 5:2 ratio. The 5:2 randomisation ratio in METEOR is due to the primary endpoint consisting of a two-stage test. See the following slide. Reference Crouse III JR et al. Measuring Effects on Intima Media Thickness: an Evaluation of 瑞舒伐他汀 in Subclinical Atherosclerosis – The Rationale and Methodology of the METEOR Study. Cardiovasc Drugs Ther 2004; 18: 231–238. Adapted from Cardiovasc Drugs Ther 2004; 18: 231–238, with permission from Springer. * This graph displays the results of the two-stage primary endpoint. It’s important when assessing the results from METEOR, to remember that the primary endpoint had 2 stages. These were (