In:
PLOS ONE, Public Library of Science (PLoS), Vol. 16, No. 1 ( 2021-1-22), p. e0245481-
Abstract:
Although accumulating evidence suggests a more extensive reduction of low-density lipoprotein cholesterol (LDL-C), it is unclear whether a higher statin dose is more effective and cost-effective in the Asian population. This study compared the efficacy, safety, and cost-effectiveness of atorvastatin 20 and 10 mg in high-risk Asian patients with hypercholesterolemia. Methods A 12-week, open-label, parallel, multicenter, Phase IV randomized controlled trial was conducted at ten hospitals in the Republic of Korea between October 2017 and May 2019. High-risk patients with hypercholesterolemia, defined according to 2015 Korean guidelines for dyslipidemia management, were eligible to participate. We randomly assigned 250 patients at risk of atherosclerotic cardiovascular disease to receive 20 mg (n = 124) or 10 mg (n = 126) of atorvastatin. The primary endpoint was the difference in the mean percentage change in LDL-C levels from baseline after 12 weeks. Cost-effectiveness was measured as an exploratory endpoint. Results LDL-C levels were reduced more significantly by atorvastatin 20 mg than by 10 mg after 12 weeks (42.4% vs. 33.5%, p 〈 0.0001). Significantly more patients achieved target LDL-C levels ( 〈 100 mg/dL for high-risk patients, 〈 70 mg/dL for very high-risk patients) with atorvastatin 20 mg than with 10 mg (40.3% vs. 25.6%, p 〈 0.05). Apolipoprotein B decreased significantly with atorvastatin 20mg versus 10 mg (−36.2% vs. −29.9%, p 〈 0.05). Lipid ratios also showed greater improvement with atorvastatin 20 mg than with 10 mg (total cholesterol/high-density lipoprotein cholesterol ratio, −33.3% vs. −29.4%, p 〈 0.05; apolipoprotein B/apolipoprotein A1 ratio, −36.7% vs. −31.4%, p 〈 0.05). Atorvastatin 20 mg was more cost-effective than atorvastatin 10 mg in terms of both the average and incremental cost-effectiveness ratios. Safety and tolerability of atorvastatin 20 mg were comparable to those of atorvastatin 10 mg. Conclusion In high-risk Asian patients with hypercholesterolemia, atorvastatin 20 mg was both efficacious in reducing LDL-C and cost-effective compared with atorvastatin 10 mg.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0245481
DOI:
10.1371/journal.pone.0245481.g001
DOI:
10.1371/journal.pone.0245481.g002
DOI:
10.1371/journal.pone.0245481.g003
DOI:
10.1371/journal.pone.0245481.g004
DOI:
10.1371/journal.pone.0245481.t001
DOI:
10.1371/journal.pone.0245481.t002
DOI:
10.1371/journal.pone.0245481.t003
DOI:
10.1371/journal.pone.0245481.t004
DOI:
10.1371/journal.pone.0245481.t005
DOI:
10.1371/journal.pone.0245481.t006
DOI:
10.1371/journal.pone.0245481.s001
DOI:
10.1371/journal.pone.0245481.s002
DOI:
10.1371/journal.pone.0245481.s003
DOI:
10.1371/journal.pone.0245481.s004
DOI:
10.1371/journal.pone.0245481.s005
DOI:
10.1371/journal.pone.0245481.s006
DOI:
10.1371/journal.pone.0245481.s007
DOI:
10.1371/journal.pone.0245481.s008
DOI:
10.1371/journal.pone.0245481.s009
DOI:
10.1371/journal.pone.0245481.s010
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2021
detail.hit.zdb_id:
2267670-3
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