Superior Benefit of Aggressive Lipid-Lowering Therapy for High- Risk Patients Using Statins: the SUBARU Study

Aim: There have been few comparisons between rosuvastatin and other statins in Japanese patients. This open-label, randomized, parallel-group comparative study was performed to compare the efficacy and safety of rosuvastatin (5 mg) and atorvastatin (10 mg) once daily in Japanese patients with hypercholesterolemia. Methods: Patients with hypercholesterolemia who had received atorvastatin (10 mg/day) for at least 4 weeks and were in category B3, B4, or C according to the Japan Atherosclerosis Society Guidelines for Diagnosis and Treatment of Atherosclerotic Cardiovascular Diseases 2002 (JAS2002GL) were randomly assigned to rosuvastatin at 5 mg/day (switched treatment) or atorvastatin at 10 mg/day (continued treatment). The primary endpoint was the achievement of JAS2002GL LDL-C goals at 8 weeks. Results: LDL-C goals were reached by 80.3% of the rosuvastatin group and 67.3% of the atorvastatin group at 8 weeks (p<0.01). The percent change of the LDL-C and LDL-C/HDL-C ratio at 8 weeks was significantly greater in the rosuvastatin group than in the atorvastatin group (both p< 0.01). Furthermore, rosuvastatin improved fasting plasma glucose (p<0.01). Both drugs were well tolerated. Conclusion: Rosuvastatin (5 mg/day) is a useful treatment option for high-risk patients with hypercholesterolemia.