Rosuvastatin: Efficacy, Safety and Clinical Effectiveness

Background: Rosuvastatin is a fully synthetic statin developed by AstraZeneca. It is a competitive inhibitor of 3-hydroxy-3-methyl-glutaryl-CoA reductase.

Objective: We reviewed the efficacy, characteristics, safety and clinical effectiveness of rosuvastatin.

Methods: We conducted a Pubmed and Medline literature search (January 2000 to March 2008) to identify all papers on rosuvastatin published in English. Other relevant papers and textbooks from the author's personal collection were also used as references.

Conclusion: Rosuvastatin has a potent low-density lipoprotein cholesterol (LDL-C) lowering action. In addition it has potentially favourable effects on high-density lipoprotein (HDL), non-HDL-C, triglycerides and the apolipoprotein B : A1 ratio. Theoretically, if assumptions about these lipoprotein effects hold true and translate to better cardiovascular outcomes, rosuvastatin could prove to be the most clinically effective statin. However, while results from vascular imaging studies are encouraging overall, it is not clear whether these will translate into favourable cardiovascular outcomes because of lack of trial results. There are, as yet, no published mortality and cardiovascular outcome data from randomised, controlled trials to support LDL-C lowering with rosuvastatin rather than other statins. However, the early termination of one outcome trial has recently been announced because of clear benefits announced from rosuvastatin therapy compared with placebo.