Rosuvastatin safety: lessons from the FDA review and post-approval surveillance.
Rosuvastatin is the first statin approved by the regulatory authorities since the withdrawal of cerivastatin. Although highly efficacious, this new statin has generated considerable controversy regarding its safety. Rosuvastatin was approved for clinical use based on the largest pre-approval database for all statins prior to commercial use. In this database, rosuvastatin had a similar safety profile to other approved statins up to the highest approval dose of 40 mg. As with all statins, there is a marked increase in adverse effects when the dose is titrated from 40 to 80 mg, and rosuvastatin demonstrates a similar dose/toxicity relationship. In the pre-approval data trials on 80 mg, there was a 1.0% (n = 16) incidence of myopathy and 7 patients developed rhabdomyolysis. However the <or= 40 mg doses had a myopathy rate similar to other statins. In the post-marketing surveillance for rosuvastatin, there have been reports of rhabdomyolysis, but the incidence rate, when corrected for prescription utilisation, is similar to other statins following initial approval.
Davidson
Michael H
MH
Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA. michaeldavidson@radiantresearch.com
D058186:Acute Kidney Injury / Q000139:chemically induced / Q000453:epidemiology; D016907:Adverse Drug Reaction Reporting Systems; D015415:Biomarkers; D008078:Cholesterol, LDL / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D052283:Creatine Kinase, MM Form; D017277:Drug Approval; D005464:Fluorobenzenes / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000097:blood / Q000188:drug therapy; D015994:Incidence; D007527:Isoenzymes / Q000097:blood; D007684:Kidney Tubules / Q000187:drug effects; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D011358:Product Surveillance, Postmarketing; D011507:Proteinuria / Q000139:chemically induced* / Q000453:epidemiology; D011725:Pyridines / Q000009:adverse effects; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D012206:Rhabdomyolysis / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000009:adverse effects* / Q000627:therapeutic use
D015415:Biomarkers; D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007527:Isoenzymes; D011725:Pyridines; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; C086276:cerivastatin; D003402:Creatine Kinase; D052283:Creatine Kinase, MM Form