Rosuvastatin-Induced Arrest in Progression of Renal DiseaseVidt D.G. · Cressman M.D. · Harris S. · Pears J.S. · Hutchinson H.G.
aCleveland Clinic Foundation, Cleveland, Ohio, bAstraZeneca LP, Wilmington, Del., USA, and cAstraZeneca, Macclesfield, UK
Preclinical and limited clinical data suggest that statins decrease the progressive decline in renal function that occurs in patients with renal disease. Pooled analysis of data obtained from a population of hyperlipidemic patients enrolled in the rosuvastatin (Crestor®) clinical development program permitted assessment of its effects on renal function both early and later in the course of treatment. Study participants were initially included in controlled clinical trials that evaluated the lipid-lowering efficacy and safety of rosuvastatin when compared with placebo or other lipid-lowering agents (i.e., atorvastatin, simvastatin, pravastatin, cholestyramine, fenofibrate or extended-release niacin). The median duration of treatment with the various doses of statins in these trials was approximately 8 weeks. Following completion of a controlled clinical trial, patients were permitted to enter an open-label extension trial and received rosuvastatin treatment. These data permitted assessment of renal function in a diverse group of over 10,000 patients who received rosuvastatin in its recommended dose range (5–40 mg) for up to 3.8 years. Mean serum creatinine concentrations were lower when compared with baseline both early and later in the course of rosuvastatin treatment. In contrast, no change in mean serum creatinine was observed with placebo. Mean glomerular filtration rates (GFR) predicted from the Modification of Diet in Renal Disease (MDRD) equation were higher when compared with baseline both early and later in the course of rosuvastatin treatment. No change in GFR was observed in the placebo group. Among patients who received long-term rosuvastatin treatment (≧96 weeks), GFR was unchanged or tended to increase, rather than decrease, when compared with baseline irrespective of age, gender, hypertensive or diabetic status, level of renal function (GFR ≧60 vs. <60 ml/min/1.73 m2) at entry or urine dipstick protein status prior to or during the period of treatment. These findings suggest that rosuvastatin may arrest the progression of renal disease.
Howard G. Hutchinson
AstraZeneca LP, FOC WI-652
Wilmington, DE 19803 (USA)
Tel. +1 302 885 1952, Fax +1 302 885 5348
AstraZeneca LP, Wilmington, Delaware, USA, and AstraZeneca, Alderley Park, Macclesfield, Cheshire, UK, supported this research. Donald Vidt is an employee of the Cleveland Clinic Foundation and a paid consultant of AstraZeneca. Michael Cressman, Susan Harris, John Pears, and Howard Hutchinson are employees of Astra- Zeneca.
Received: February 17, 2004
Accepted: February 26, 2004
Published online: April 2, 2004
Number of Print Pages : 9
Number of Figures : 1, Number of Tables : 6, Number of References : 35
Cardiology (International Journal of Cardiovascular Medicine, Surgery and Pathology)
Founded 1937 as ‘Cardiologia’ by Bruno Kisch and Wilhelm Löffler
Vol. 102, No. 1, Year 2004 (Cover Date: Released April 2004)
Journal Editor: Joseph S. Alpert, Tucson, Ariz.
ISSN: 0008–6312 (print), 1421–9751 (Online)
For additional information: http://www.karger.com/journals/crd