title: Pharmacokinetic and pharmacodynamic profile of rosuvastatin in patients with end-stage renal disease on chronic haemodialysis.
abstract: BACKGROUND
  Rosuvastatin has been shown to provide effective treatment of dyslipidaemia in patients with end-stage renal disease (ESRD) undergoing haemodialysis, but data from controlled trials are very limited on the pharmacokinetics and pharmacodynamics of rosuvastatin in this population.
  
  
  OBJECTIVE
  The aim of the present study was to better define the pharmacokinetic and pharmacodynamic profiles of repeated doses of rosuvastatin at a starting dose of 10 mg/day in a group of patients with ESRD.
  
  
  METHODS
  This was a single-centre, open-label study of rosuvastatin 10 mg daily, given over a 16-day treatment period in patients with ESRD undergoing chronic haemodialysis.
  
  
  METHODS
  The study was carried out at a single site in the USA.
  
  
  METHODS
  Patients aged 18-65 years with ESRD who had been on dialysis for ≥ 3 months were eligible for inclusion. Of 12 patients enrolled, 11 were included in the pharmacokinetic and pharmacodynamic analysis and all were included in the safety evaluation. The mean age of patients was 43.9 years (range 24-60 years). Five patients were Caucasian, six were black and one was Hispanic.
  
  
  METHODS
  Patients received an oral dose of rosuvastatin 10 mg once daily in the morning for 16 consecutive days.
  
  
  METHODS
  The primary objective was to estimate the degree of rosuvastatin accumulation in plasma by measuring the area under the plasma concentration time curve (AUC) from time zero to 24 h following a single dose of rosuvastatin 10 mg on day 1, and the AUC at steady state on day 15.
  
  
  RESULTS
  Following administration of single and multiple doses, plasma concentrations of rosuvastatin declined in an apparent bi-exponential manner and remained above the limit of assay detection throughout the entire sampling periods on both day 1 and day 15. Steady-state plasma concentrations of rosuvastatin were achieved by day 11. Little accumulation of rosuvastatin after repeated, once-daily dosing was observed; the geometric mean accumulation ratio for rosuvastatin was 1.37 (coefficient of variation = 36.4 %). Clearance of rosuvastatin and its metabolites via dialysis was minimal. Following rosuvastatin 10 mg daily for 16 days, total cholesterol, low-density lipoprotein cholesterol and apolipoprotein B were reduced from baseline by 30.6 %, 38.9 % and 30.6 %, respectively. Rosuvastatin was well tolerated.
  
  
  CONCLUSIONS
  The degree of rosuvastatin accumulation observed in patients receiving dialysis is similar to that in healthy individuals. The results of the current study suggest that rosuvastatin 10 mg may be administered to patients with ESRD on chronic haemodialysis without need for dose reduction.
authors.affiliation: AstraZeneca, Wilmington, DE, USA.
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Birmingham
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Swan
authors.forename: Tom
authors.initials: T
authors.lastname: Puchalski
authors.forename: Pat
authors.initials: P
authors.lastname: Mitchell
authors.forename: Connie
authors.initials: C
authors.lastname: Azumaya
authors.forename: Julie
authors.initials: J
authors.lastname: Zalikowski
authors.forename: Yi
authors.initials: Y
authors.lastname: Wang
mesh_terms: D005464:Fluorobenzenes / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D011743:Pyrimidines / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use; D006435:Renal Dialysis; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000493:pharmacokinetics* / Q000494:pharmacology / Q000627:therapeutic use
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium