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Sunday, December 28, 2008

rosuvastatin reduces the risk of cardiovascular events by 54% in people who do not have high cholesterol level after 2 years

The JUPITER (Justification for the Use of Statins in Primary Prevention Intervention) trial has shown that rosuvastatin reduces the risk of cardiovascular events by 54% in people who do not have high cholesterol level but have raised high sensitive C reactive protein. The trial was scheduled for a follow up of 4 years, but after nearly two years as there was a significant reduction in the primary end point at two years tyhe trial was stopped.

The original research article and an editorial was recently published in NEJM. There are two important issues regarding the results of this trial

1. Long term safety of rosuvastatin is not yet established. If we are going to start rosuvastatin for a low risk subject without any clinical disease for primary prevention, he will be taking it for a long period say 20 years. In such case without long term safety being established, it should not be advised.

2. Secondly the patency of rosuvastatin is now held by Astra Zeneca and the drug is very costly now. If this protective effect is a class effect then the cheaper statins which have become generic can be substituted.

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