Key result
In simulated clinical trials, treatment with rosuvastatin resulted in greater reductions in major adverse cardiac events at 5 years compared to atorvastatin (RR 0.897 for 20 mg vs 40 mg; P<0.05).
Why the study?
Does rosuvastatin reduce major adverse cardiac events compared to atorvastatin in simulated clinical trials?
Does rosuvastatin reduce major adverse cardiac events compared to atorvastatin in simulated clinical trials?
Computer-simulated trials using the Archimedes model suggest that rosuvastatin may lead to greater reductions in major adverse cardiac events compared to atorvastatin.
OBJECTIVE: No clinical trials have been conducted to directly compare the effect of the two high-intensity statins, rosuvastatin and atorvastatin, on cardiovascular outcomes. However, three such trials have been computer-simulated using the Archimedes model, an individual-based simulation of human physiology and behaviors, treatment interventions, and health care systems. The results are reviewed here. METHODS: The first simulated trial assessed clinical outcomes in patients receiving available doses of the two drugs. The second assessed the impact of initial treatment decisions, while the third assessed the effect of switching from rosuvastatin to atorvastatin. RESULTS: In the first simulated trial, treatment with rosuvastatin was estimated to result in greater reductions than treatment with atorvastatin in major adverse cardiac event (MACE) rates at 5 years and 20 years at all doses examined (relative risk [RR]: 0.897, 0.888, and 0.930 at 5 years for rosuvastatin 20 mg vs atorvastatin 40 mg, rosuvastatin 40 mg vs atorvastatin 80 mg, and rosuvastatin 20 mg vs atorvastatin 80 mg, respectively; all P<0.05). In the second simulated trial, outcomes were significantly better in patients initially prescribed rosuvastatin than in those initially prescribed atorvastatin (RR of MACE at 5 years: 0.918; P<0.001). In the third simulated trial, risk of MACE was significantly greater in patients switching from rosuvastatin to atorvastatin than in those remaining on rosuvastatin (RR at 5 years: 1.109; P<0.001). CONCLUSION: The results of these simulated clinical trials suggest improved outcomes among patients receiving rosuvastatin relative to patients receiving atorvastatin in various clinical settings.
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Sternhufvud et al. (2015) reported a review. Rosuvastatin vs. Atorvastatin (40 mg or 80 mg) was evaluated on Major adverse cardiac event (MACE) (RR 0.897, p=<0.05). In simulated clinical trials, treatment with rosuvastatin resulted in greater reductions in major adverse cardiac events at 5 years compared to atorvastatin (RR 0.897 for 20 mg vs 40 mg; P<0.05).
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