Pharmacoeconomics study of rosuvastatin single daily dose versus alternate day dosing in hyperlipidemia patients

Background: In country like India, therapy with rosuvastatin recommended dose may cost between Rs. 400.00 and Rs. 800.00/month. The lower and middle income groups of Indian society are rapidly becoming major sufferers of cardiovascular disease, among all non-communicable diseases, the economic burden of rosuvastatin therapy may be substantial for this large section of population. Aims and Objectives: The aim of the study was to study the cost-effectiveness of rosuvastatin on alternate day versus daily dosing regimen in hyperlipidemia patients. Materials and Methods: The research was carried out at MNR Medical College and Hospital’s department of pharmacology in association with general medicine. According to the inclusion criteria, 50 patients aged 30–60 years of both sexes were included in this prospective open label trial. The research lasted 6 weeks. All the participants were included in study after obtaining the informed consent and approval of the Institutional Ethics Committee was obtained before enrolment of participants. All patient data were obtained using a pre-designed proforma and put into an excel spreadsheet. Results: A total of 42 patients are included with 16 females (38%) and 26 men (62%). Cost of daily rosuvastatin for 6 weeks is Rs. 1087.80 (yearly daily dosing expenses 9453.50%) accounting for mean reduction of LDL-cholesterol (LDL-C) of 33.50% and for alternate day rosuvastatin for 6 weeks is 543.90% (yearly alternate day dosing expense 4713.80%) accounting for mean reduction of LDL-C of 31%. Conclusion: Treatment with alternate day dose of rosuvastatin is comparably cost-effective when compared to currently practicing daily dose rosuvastatin therapy.

Evaluation of the therapeutic benefits of single daily dose versus alternate day dose of rosuvastatin in hyperlipidemia patients

Background: The common cause of mortality in India is related to complications of cardiovascular disease which has direct relation with the hyperlipidemia, diabetes mellitus, and hypertension. Rosuvastatin more efficacious than other statins in lesser dosage and having good safety profile. Aim and Objective: The present study was undertaken to evaluate the safety, efficacy of rosuvastatin 10 mg daily dose versus alternate day dose in hyperlipidemia patients. Materials and Methods: A total of 50 individuals with hyperlipidemia were selected in this prospective open label research. Patients were grouped as Group D with rosuvastatin daily dose and Group A with alternate day dose. Fasting plasma lipid profile was assessed in both groups on the 1st, 4th, and 6th weeks. Results: There is significant reduction in total cholesterol, low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), and elevation of high-density lipoprotein (HDL) after 4 weeks and 6 weeks of the treatment in both the groups compared to baseline. The mean percentage reduction of total cholesterol was by 24% and 21.60% (P < 0.05) in Group D and Group A, respectively. The mean percentage reduction of LDL-C was by 33.50% and 31% (P < 0.05) Group D and Group A, respectively. The mean percentage improvement of HDL-cholesterol was by 19.89% and 17.09% (P < 0.05) in Group D and Group A, respectively. The mean percentage of reduction of TG was by 36.70% and 41.33% (P < 0.05) Group D and Group A. Conclusion: Rosuvastatin 10 mg on alternate days had the same efficacy in lowering cholesterol levels as taking it every day, also it may be a cost-effective alternative without sacrificing therapeutic benefits or side effects.

Safety and efficacy of short-term dual antiplatelet therapy combined with intensive rosuvastatin in acute ischemic stroke

Abstract Objective: To investigate the safety and efficacy of short-term (7-day) Dual Antiplatelet Therapy (DAPT) with intensive rosuvastatin in Acute Ischemic Stroke (AIS). Methods: In this study, patients with AIS in the emergency department of the hospital from October 2016 to December 2019 were registered and divided into the control group (Single Antiplatelet Therapy [SAPT] + rosuvastatin) and the study group (7-day DAPT + intensive rosuvastatin) according to the therapy regimens. The generalized linear model was used to compare the National Institute of Health Stroke Scale (NIHSS) scores between the two groups during the 21-day treatment. A Cox regression model was used to compare recurrent ischemic stroke, bleeding events, Statin-Induced Liver Injury (SILI), and Statin-Associated Myopathy (SAM) between the two groups during the 90-day follow-up. Results: Comparison of NIHSS scores after 21-day treatment: NIHSS scores in the study group decreased significantly, 0.273-times as much as that in the control group (Odds Ratio [OR] 0.273; 95% Confidence Interval [95% CI] 0.208-0.359; p < 0.001). Comparison of recurrent ischemic stroke during the 90-day follow-up: The therapy of the study group reduced the risk of recurrent stroke by 65% (7.76% vs. 22.82%, Hazard Ratio [HR] 0.350; 95% CI 0.167-0.730; p = 0.005). Comparison of bleeding events: There was no statistical difference between the two groups (7.79% vs. 6.71%, HR = 1.076; 95% CI 0.424-2.732; p = 0.878). No cases of SILI and SAM were found. Conclusions: Short-term DAPT with intensive rosuvastatin effectively relieved the clinical symptoms and significantly reduced the recurrent stroke for patients with mild-to-moderate AIS within 90 days, without increasing bleeding events, SILI and SAM.

Comparative effect of 1.2% atorvastatin gel and 1.2% rosuvastatin as a local drug delivery in treatment of intra-bony defects in chronic periodontitis

Background: The present study was aimed to evaluate the efficacy of 1.2% Atorvastatin (ATV) with 1.2% Rosuvastatin (RSV) as local drug delivery for treatment of Chronic Periodontitis (CP). Materials and Methods: Forty patients were equally divided into two groups. Group A underwent scaling and root debridement and 1.2% ATV gel (1.2 mg/0.1 mL) was placed, whereas group B received scaling and root debridement and RSV (1.2 mg/0.1 ml) was placed. Results: The results showed that both the groups had improvement in all the recorded parameters, and the results obtained were statistically significant. When comparison was made between the groups, no significant difference was obtained between atorvastatin and rosuvastatin at baseline in all recorded parameters. However, after 6 months significant improvement was recorded in CAL (Clinical attachment level) and PD (Probing depth). The plaque index (PI) and gingival index (GI) score however showed improvement, but it did not attain the level of significance. Conclusion: The present study showed improvement in clinical parameters with the use of ATV and RSV gel when used in combination with scaling and root planing (SRP) in CP patients. Patients with RSV gel showed up significantly better than the ones in which ATV gel was placed.

Is rosuvastatin protective against sepsis-associated encephalopathy? A secondary analysis of the SAILS trial / 世界急诊医学杂志（英文）

@#BACKGROUND: Sepsis is a common cause of death in emergency departments and sepsis-associated encephalopathy (SAE) is a major complication. Rosuvastatin may play a neuroprotective role due to its protective effects on the vascular endothelium and its anti-inflammatory functions. Our study aimed to explore the potential protective function of rosuvastatin against SAE. METHODS: Sepsis patients without any neurological dysfunction on admission were prospectively enrolled in the “Rosuvastatin for Sepsis-Associated Acute Respiratory Distress Syndrome” study (SAILS trial, ClinicalTrials.gov number: NCT00979121). Patients were divided into rosuvastatin and placebo groups. This is a secondary analysis of the SAILS dataset. Baseline characteristics, therapy outcomes, and adverse drug events were compared between groups. RESULTS: A total of 86 patients were eligible for our study. Of these patients, 51 were treated with rosuvastatin. There were significantly fewer cases of SAE in the rosuvastatin group than in the placebo group (32.1% vs. 57.1%, P=0.028). However, creatine kinase levels were significantly higher in the rosuvastatin group than in the placebo group (233 [22-689] U/L vs. 79 [12-206] U/L, P=0.034). CONCLUSION: Rosuvastatin appears to have a protective role against SAE but may result in a higher incidence of adverse events.

Protective effect of N-acetyl-L-cysteine and rosuvastatin against oxidative stress in fibroblasts from asymptomatic patients with X-ALD: a preliminary study

Introduction: Several studies in the literature have evaluated the role of oxidative stress and adjuvant therapies for X-linked adrenoleukodystrophy (X-ALD). Here, we investigated whether n-acetyl-L-cysteine (NAC) and rosuvastatin (RSV) could influence the generation of reactive species, redox status and nitrative stress in fibroblasts from asymptomatic patients with X-ALD. Methods: Skin biopsy samples were cultured and treated for 2 hours (37 °C) with NAC and RSV. Results: X-ALD fibroblasts generated high levels of reactive oxygen species. These levels were significantly lower in fibroblasts treated with NAC and RSV relative to untreated samples. The X-ALD fibroblasts from asymptomatic patients also had higher catalase activity, and only NAC was able to increase enzyme activity in the samples. Conclusions: Our results indicated that NAC and RSV were able to improve oxidative stress parameters in fibroblasts from asymptomatic patients with X-ALD, showing that adjuvant antioxidant therapy may be a promising treatment strategy for asymptomatic patients with this disease. (AU)

Analysis of influencing factors of acute kidney injury in coronary artery bypass grafting patients treated with different statins / 中华急诊医学杂志

Objective:To compare the effects of rosuvastatin and atorvastatin on coronary artery bypass grafting (CABG) on the incidence of acute kidney injury (AKI), and assess the independent risk factors of AKI.Methods:We retrospectively collected 550 patients aged 18 years or older who underwent CABG from May 2014 to May 2020. They were divided into the rosuvastatin group ( n=322), atorvastatin group ( n=125) and non statins group ( n=103) according to whether rosuvastatin or atorvastatin was routinely used before operation. Demographic data, clinical data before and after CABG and laboratory results were collected. Blood urea nitrogen (BUN), serum creatinine (Scr), creatinine clearance rate (Ccr) and incidence of postoperative AKI were compared among the three groups. Univariate analysis and binary logistic regression analysis were used to investigate the effect of statins on AKI in patients undergoing CABG. Results:Compared with preoperation, BUN showed no significant change ( P>0.05), while Scr was increased and Ccr was decreased significantly (both P<0.01); BUN in the rosuvastatin group was decreased significantly ( P<0.01), whereas Scr and Ccr had no significant change ( P>0.05); Scr in the atorvastatin group was increased significantly ( P<0.01), but there was no significant difference in BUN and Ccr ( P>0.05). BUN and Scr in the non statins group were increased significantly (both P<0.01), while Ccr was decreased significantly ( P<0.01). After operation, BUN and Scr in the rosuvastatin group and atorvastatin group were significantly lower than those in the non statins group (all P<0.01); Ccr was significantly higher than that in the non statins group ( P<0.01). BUN and Scr were not significantly different between the rosuvastatin and atorvastatin groups ( P>0.05), but Ccr was significantly higher than that in the atorvastatin group ( P< 0.05). There were significant differences in BUN, Scr and Ccr among the three groups ( χ2=48.925, 22.677 and 34.426, all P<0.01). The incidence of AKI among 550 patients was 15.1% (83/550), of which 9.6% (31/322) in the rosuvastatin group, 16.0% (20/125) in the atorvastatin group and 31.1% (32/103) in the non statins group. The incidence of AKI in the rosuvastatin and atorvastatin groups was significantly lower than that in the non statins group ( χ2=28.412, 7.282, P<0.01). Multivariate regression analysis showed that hypertension ( OR=3.555, 95% CI: 1.959-6.451, P<0.01), NHYAⅢ/Ⅳ ( OR=2.438, 95% CI: 1.187-5.008, P=0.015), and increased serum creatinine level ( OR=1.018, 95% CI: 1.003-1.032, P=0.016), and intraoperative cardiopulmonary bypass ( OR=2.936, 95% CI: 1.454-5.927, P=0.003) were independent risk factors for AKI after CABG, while preoperative conventional statin therapy ( OR=0.490, 95% CI: 0.247-0.974, P=0.042) and increased serum albumin level ( OR=0.920, 95% CI: 0.856-0.990, P=0.026) were protective factors for AKI after CABG. Conclusions:The incidence of AKI after CABG is common. Rosuvastatin or atorvastatin and increased preoperative serum albumin level can protect renal function and reduce the incidence of AKI, which are the protective factors of AKI after CABG. The hypertension, NHYAⅢ/Ⅳ, increased preoperative serum creatinine level and cardiopulmonary bypass are the independent risk factors of AKI after CABG.

Application of the artificial neural network to optimize the formulation of self-nanoemulsifying drug delivery system containing rosuvastatin

The objectives of this study were to optimize the formula of the self-nanoemulsifying drug delivery system (SNEDDS)containing rosuvastatin and to evaluate its physicochemical characteristics. The solubility and compatibility ofrosuvastatin in surfactants, cosurfactants, and oil excipients were evaluated. The D-optimal experimental design,created by JMP 15 software, was used for analyzing the effects of excipients on the physicochemical characteristicsof SNEDDS to optimize the rosuvastatin SNEDDS formula. The generated nanoemulsions from Ros SNEDDS werecharacterized for droplet size, polydispersity index, and entrapment efficiency. As a result, Cremophor RH40, Capryol90, and PEG 400 were selected to develop the pseudoternary phase diagram to identify the area capable of selfforming nanoemulsion. As the percentage of rosuvastatin calcium increased from 8% to 12%, the area for optimizingthe formula of Ros SNEDDS decreased. The Ros SNEDDS prepared according to predicted formulas possessed selfemulsification to form nanoemulsion with average droplet size less than 100 nm, polydispersity index less than 0.3,and rosuvastatin entrapment higher than 90%.

Chitosan-sodium Alginate Nanoparticle as a Promising Approach for Oral Delivery of Rosuvastatin Calcium: Formulation, Optimization and In vitro Characterization

Rosuvastatin calcium is the most effective antilipidemicdrug and is called "super-statin" but it exhibits low aqueous solubility and poor oral bioavailability of about 20%. The present work aimed to develop and optimize chitosan-alginate nanoparticulate formulation of rosuvastatin which can improve its solubility, dissolution and therapeutic efficacy. Chitosan-alginate nanoparticles were prepared by ionotropic pre-gelation of an alginate core followed by chitosan polyelectrolyte complexation and optimization was done in terms of two biopolymers, crosslinker concentrations. The chitosan-alginate nanoparticles were characterized by various techniques such as particle properties such as size; size distribution (polydispersity index); Zeta-potential measurements and Fourier transform infrared spectra respectively. The designed rosuvastatin loaded chitosan-alginate nanoparticle had the average particle size of 349.3 nm with the zeta potential of +29.1 mV, and had high drug loading and entrapment efficiencies. Fourier transform infrared spectra showed no chemical interaction between the rosuvastatin and chitosan-alginate nanoparticle upon the encapsulation of rosuvastatin within the nanoparticles. Nanoparticles revealed a fast release during the first two hours followed by a more gradual drug release during a 24h period. Hence, our studies demonstrated that the new chitosan-alginate nanoparticle system of rosuvastatin is a promising strategy for improving solubility and in turn, the therapeutic efficacy of rosuvastatin. Therefore, the rosuvastatin-loaded chitosan-alginate nanoparticles are a promising approach for the oral delivery of rosuvastatin.

Development Of Microemulsion Formulation For Oral Delivery Of Rosuvastatin Calcium

The purpose of conducting this study was to prepare an oral microemulsion formulation of Rosuvastatin calcium (RC) to improve its water solubility. Oil in water microemulsion was formulated using Oleic acid, Tween 80 and Polyethylene Glycol-400(PEG-400) as oil, surfactant and co-surfactant, respectively. The ideal proportion of surfactant: co-surfactant (Smix) was chosen by constructing pseudoternary diagrams. The microemulsion formulations which proved to be stable after thermodynamic stability testing were further evaluated for physical characteristics. Selected formulations were evaluated for droplet size, zeta potential, polydispersity index, viscosity and % drug content. The results were suggestive that optimized microemulsion formulation (F2) was thermodynamically stable and clear having a droplet size of 74.29 nm and zeta potential of -18.44. In vitro dissolution study for optimized microemulsion was performed using a dialysis bag method and cumulative % drug release was determined. The result from the release study was indicative of improved solubility of Rosuvastatin calcium which may serve to boost up the oral bioavailability of drug.

Possible mechanisms involved in the effect of the subchronic administration of rosuvastatin on endothelial function in rats with metabolic syndrome

Metabolic syndrome is a multifaceted condition associated with a greater risk of various disorders (e.g., diabetes and heart disease). In a rat model of metabolic syndrome, an acute in vitro application of rosuvastatin causes relaxation of aortic rings. Since the outcome of a subchronic rosuvastatin treatment is unknown, the present study explored its effect on acetylcholine-induced vasorelaxation of aortic rings from rats with metabolic syndrome. Animals were submitted to a 16-week treatment, including a standard diet, a cafeteria-style diet (CAF-diet), or a CAF-diet with daily rosuvastatin treatment (10 mg/kg). After confirming the development of metabolic syndrome in rats, aortic segments were extracted from these animals (those treated with rosuvastatin and untreated) and the acetylcholine-induced relaxant effect on the corresponding rings was evaluated. Concentration-response curves were constructed for this effect in the presence/absence of L-NAME, ODQ, KT 5823, 4-aminopyridine (4-AP), tetraethylammonium (TEA), apamin plus charybdotoxin, glibenclamide, indomethacin, clotrimazole, and cycloheximide pretreatment. Compared to rings from control rats, acetylcholine-induced vasorelaxation decreased in rings from animals with metabolic syndrome, and was maintained at a normal level in animals with metabolic syndrome plus rosuvastatin treatment. The effect of rosuvastatin was inhibited by L-NAME, ODQ, KT 5823, TEA, apamin plus charybdotoxin, but unaffected by 4-AP, glibenclamide, indomethacin, clotrimazole, or cycloheximide. In conclusion, the subchronic administration of rosuvastatin to rats with metabolic syndrome improved the acetylcholine-induced relaxant response, involving stimulation of the NO/cGMP/PKG/Ca2+-activated K+ channel pathway.

Synthesis of the Related Substances of Rosuvastatin / 中国药学杂志

OBJECTIVE: To synthesize three related substances of rosuvastatin and establish its standard quality control system. METHODS: t-Butyl-6-[(1E)-2-[4-(4-fluorophenyl)-6-isopropanyl-2-[methyl(methylsulfonyl)amino]-5-pyrimidinyl]ethenyl]-2,2-dimethyl-1,3-dioxane-4-acetate (1a) was converted into the de-ketal compound 1b, then the latter underwent hydrolysis to get 1c. Finally, N-[4-(4-fluorophenyl)-6-isopropanyl-5-[(1E)-2-[(2S, 4R)-4-hydroxyl-6-oxo-2H-pyran-2-ethenyl]-2-pyrimidinyl]-N-methyl methane sulfonamide (impurity 1) was obtained through intramolecular dehydration. Meanwhile, (3R, 5S, 6E)-7-[4-(4-fluoropheny-1)-6-isopropanyl-2-[methyl(methylsulfonyl)amino]-pyrimidin-5-yl]-3,5-dihydroxy-6-heptenoic acid (impurity 2) was prepared from compound 1b via oxidation with DDQ, reduction with tetramethylammonium triacetoxyborohydride, followed by hydrolysis. (3R, 6E)-7-[4-(4-fluorophenyl)-6-isopropanyl-2-[methyl(methylsulfonyl) amino]-5-pyrimidinyl]-3-hydroxy-5-oxo-6-heptenoic acid (impurity 3) was synthesized through oxidation of compound 1c with DDQ. RESULTS: The structures of three impurities were confirmed by 1H-NMR and MS. CONCLUSION: The synthesized three target compounds can be used as references for the quality control of rosuvastatin calcium.

Simultaneous determination of rosuvastatin, atorvastatin and their metabolites in human plasma by UPLC-MS/MS / 国际药学研究杂志

Objective: To develop a ultra performance liquid chromatography- tandem mass spectrometry(UPLC- MS/MS) method for the simultaneous determination of rosuvastatin(RT), atorvastatin(AT)and their metabolites, i.e., atorvastatin lactone (ATL), ortho- hydroxy-atorvastatin(O-AT)and para-hydroxy-atorvastatin(P-AT), in human plasma. Methods: Deuterium-labeled compounds, RT-d6, AT-d5 and P-AT-d5 were used as the internal standards(IS). The plasma samples were extracted with ethyl acetate. The chromatographic separation was achieved on a ACQUITY UPLCTM BEH C18 column(50 mm×2.1 mm, 1.7 μm)with the mobile phase of 0.2%(v/v)formic acid aqueous solution and methanol by gradient elution. The flow rate was 0.2 ml/min, and the column temperature was 40℃. Analytes were detected on a tandem mass spectrometer, equipped with an electrospray ionization source that was operated in the positive mode. The selectivity, standard curve, precision and accuracy, extraction recoveries, matrix effect, and stability were investigated. Results: The linear range of RT was 0.1-50 ng/ml with r2 =0.9977. The linear range for AT, ATL, O-AT and P-AT was 0.05-50 ng/ml with r2 =0.9997, 0.9988, 0.9923 and 0.9995, respectively. Conclusion: The established method is rapid, sensitive, accurate, specific and reliable, which is suitable for the simultaneous determination of RT, AT and their metabolites in human plasma.

A Rapid Health Technology Assessment of Rosuvastatin Applicated in Patients with Dyslipidemia / 中国药房

OBJECTIVE：To rapidly evaluate the effectiveness，safety and economics of rosuvastatin （RSV）in the treatment of dyslipidemia，so as to provide evidence-based support for clinical drug use. METHODS ：Retrieved from PubMed ，Embase， Cochrane Library ，CNKI，Wanfang database and CBM ，etc.，health technology assessment （HTA）related website and database were searched systematically to select HTA report ，Meta-analysis/systemic evaluation and pharmacoeconomics study about RSV versus placebo or other positive drugs in the treatment of dyslipidemia. According to the inclusion and exclusion criteria ，two researchers independently screened the literatures ，extracted and summarized the data ，then performed qualitative description of results. RESULTS ：Totally 11 Meta-analysis and 11 pharmacoeconomic studies were included ，and no relevant HTA report was retrieved. Results of the study showed that compared with the control group ，RSV could regulate dyslipidemia ，and reduce the levels of LDL-C ，TG，TC，C-reactive protein and sdLDL ；RSV could also reverse atherosclerotic plaque ，reduce all-cause mortality with good safety. In terms of economy ，compared with other statins or placebo ，RSV could prolong quality-adjusted life year，its incremental cost-effectiveness ratio is lower than the desired payment threshold ，which had more economic advantages. CONCLUSIONS：RSV is effective ，safe and economical in the treatment of hyperlipidemia.

Effect of Pitavastatin in Patients with Active Rheumatoid Arthritis Treated at a Tertiary Care Hospital

Introduction: Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder, autoimmune in nature that predominatelyaffects synovial joints. Being a crippling disease is a leading cause of disability that often reduces the quality of life and impairspatients ability to work.Aims and Objectives: The aim of the study was to compare the effect of different treatment regimens on patients with activeRA treated at a tertiary care hospital.Materials and Methods: This was a prospective, open labeled, parallel arm, randomized, and single-center study performed ina tertiary care teaching hospital (Chennai Medical College Hospital and Research Centre [SRM Groups], Irungalur, Tiruchirapalli)and was conducted at outpatient clinics. Total duration of the study period was 24 weeks. All the patients were having activeRA and were on oral methotrexate (first-line disease-modifying antirheumatic drug) at the time of recruitment.Statistical Analysis: All the data were initially entered into Microsoft Excel 2010 and later these spreadsheets were used foranalysis. Statistical analysis was done using SPSS version 20.0.Conclusion: Combination therapy of pitavastatin and methotrexate is better than methotrexate monotherapy and combinationtherapy of rosuvastatin and methotrexate.

Cost comparisons of seven leading brands of the Hypolipidemic drug, Rosuvastatin available in an India city

Background: Hypolipidemic drugs need to be prescribed lifelong for most of the selected patients, once started. Price variation can lead to huge financial strain on the patients, especially when cost associated issues are not considered by the prescribing medical practitioner. This study was conducted to compare the cost, to the patient, of seven most commonly prescribed preparations of different brands of Rosuvastatin ten milligram, in Kolhapur city.Methods: Authors purchased a strip of 10 capsules each of the seven leading brands of Rosuvastatin ten milligrams. The prices of the strip of 10 capsules of each of the seven chosen brands were compared. Finally, the cost of each of these seven brands for one year, was compared directly as well as using percentages. The data was collected, analysed and presented in tabular forms and figures.Results: The data of the cost of seven different brands of a single hypolipidemic drug, Rosuvastatin ten milligram shows that the cost of the costliest among the seven brands of this drug for one year is almost two times that of the cheapest brand, or in other words almost 200 percent that of the cheapest brand.Conclusions: The cost differences between the cheapest and the costliest brands were substantial. The cost of remaining five brands was dispersed in between these two extremes. India, with a major part of the population being highly concerned about the cost of medications, the prescribing medical practitioner must select the preparation wisely . The most costly preparation of Rosuvastatin ten milligram can substantially add to the financial strain on the patient’s yearly expenses. Thus, Pharmaco economic considerations must be a prime concern while making a decision to prescribe medicines, especially in a country like India.

Impact of Rosuvastatin in Systolic Heart Failure among elderly patients- A randomized control clinical trial

Background: Patients with systolic heart failure have generally been excluded from statin trials. Acute coronary events are uncommon in this population, and statins have theoretical risks in these patients. Objective: To evaluate the impact of Rosuvastatin in patient of Systolic Heart Failure. Materials and methods: A randomized controlled clinical trial was conducted among 500 patients of at least 60 years of age with New York Heart Association class II, III, or IV ischemic, systolic heart failure. The patients were randomly allocated to accept 10 mg of rosuvastatin or placebo per day. The primary composite outcome was death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke. Epi-info was used for analysis. Results: As compared with the placebo group, patients in the rosuvastatin group had decreased levels of low-density lipoprotein cholesterol (P<0.001) and of high-sensitivity C-reactive (P<0.001). During a median follow-up of 30 months, the primary outcome occurred in 500 patients in the rosuvastatin group and 700 in the placebo group (hazard ratio, 0.92; 95% confidence interval (CI), 0.83 to 1.02; P = 0.12. There were no significant differences between the two groups in the coronary outcome or death from cardiovascular causes. No excessive episodes of muscle-related or other adverse events occurred in the rosuvastatin group. Conclusions: Rosuvastatin did not reduce the primary outcome or the number of deaths from any cause in older patients with systolic heart failure, although the drug did reduce the number of cardiovascular hospitalizations.

Cardioprotection of Rosuvastatin Pre-conditioning on Myocardial Ischemia / Reperfusion Injury in a Rat Model

Abstract This study aimed to investigate the cardioprotection of rosuvastatin pre-conditioning (R-Pre) in a rat model of myocardial ischemia / reperfusion (I/R). Male SD rats were assigned into three groups: sham group, I/R group and R-Pre group. Rats in I/R group and R-Pre group received ischemia for 30 min and reperfusion for 2 h. In R-Pre group, rats received intragastrical administration with rosuvastatin at 5 mg/kg once daily for 1 week. After 2-h reperfusion, the cardiac function was detected by ultrasonography; the blood was collected for biochemical analysis; the heart was collected for the TUNEL staining and immunohistochemistry for Bcl-2 and Bax. Our results showed rosuvastatin pre-conditioning for 1 week could significantly reduce the infarct ratio and improve the cardiac function after myocardial I/R injury, in which attenuation of oxidative stress and cell apoptosis played an important role. Our study provides evidence on the cardioprotection of rosuvastatin pre-conditioning and highlight the use of rosuvastatin before cardiopulmonary bypass.

Effects of Atorvastatin, Rosuvastatin, and Pravastatin on Antiplatelet Activity of Clopidogrel in Patients with Acute Coronary Syndrome and Different CYP2C19 Genotypes / 中国药学杂志

OBJECTIVE: To investigate the effects of atorvastatin, rosuvastatin, and pravastatin on antiplatelet activity of clopidogrel in patients with acute coronary syndrome(ACS) and different CYP2C19 genotypes. METHODS: Between November 2017 and November 2018, a total of 300 patients admitted for ACS were enrolled in this study and randomly assigned to three groups. All patients received standard dual antiplatelet therapy. A, B, and C groups received atorvastatin calcium 20 mg•d-1, rosuvastatin calcium 20 mg•d-1, and pravastatin sodium 20 mg•d-1, respectively. The CYP2C19 genotype was detected by pyrosequencing. Thromboelastogram(TEG) was applied to detect the ADP-induced platelet inhibition rate 7 days after treatment. RESULTS: No significant difference was observed in baseline clinical characteristics between three groups. It was also no statistically significant difference in ADP inhibition rate and proportion of clopidogrel resistance between three groups(P>0.05). However, compared with rosuvastatin group and pravastatin group, the ADP inhibition rate was significantly reduced in atorvastatin group in poor metabolizers of CYP2C19. CONCLUSION: In intermediate metabolizers and extensive metabolizers of CYP2C19, there is no significant difference in the effects of atorvastatin, rosuvastatin, and pravastatin on antiplatelet activity of clopidogrel. Compared with rosuvastatin and pravastatin, atorvastatin significantly attenuates the antiplatelet function of clopidogrel in poor metabolizers of CYP2C19.

Effect and mechanism of rosuvastatin preconditioning on inflammatory cytokines release in vascular smooth muscle cells of middle cerebral artery of rats after focal cerebral ischemia-reperfusion / 解剖学报

Objective To explore the effect and probable mechanism of rosuvastatin preconditioning on inflammatory cytokines interleukin (IL) -1β, IL-6 and tumor necrosis factor a (TNF-α) release in vascular smooth muscle cells (VSMCs) of middle cerebral artery after ischemia-reperfusion. Methods Thirty-six healthy SD rats were randomly assigned into three groups; sham operation group, focal cerebral ischemia-reperfusion group and rosuvastatin preconditioning group. There were 12 rats in each group. At the 24th hour of reperfusion after middle cerebral artery occlusion (MCAO) for 2 hours, the mRNA and protein expression of IL-1β, IL-6 and TNF-α release in VSMCs of middle cerebral artery were detected by Real-time PCR and Western blotting, respectively. Also, the mRNA and protein expression of nuclear factor κB (NF-κB) were measured by Real-time PCR and Western blotting. Results At the 24th hour of reperfusion after MCAO for 2 hours, the mRNA and protein expression of IL-Iβ, IL-6 and TNF-ot were markedly up-regulated in rats of model group; rosuvastatin preconditioning can significantly inhibited overexpression of IL-1β, IL-6 and TNF-ot at the mRNA and protein levels. And the decreasing of mRNA and protein expression of NF-κB was also found in this study. Conclusion Rosuvastatin preconditioning can decrease the release of inflammatory cytokines IL-1β, IL-6 and TNF-α in VSMCs of MCA. It can relieve the inflammatory injury after ischemia-reperfusion in brain. The effect of rovastatin on IL-1β,IL-6 and TNF-ot may be related to the reduction of the expression of NF-κB in VSMCs.