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Latest statin is strongest to date

It could help patients who've had little success with other cholesterol-lowering drugs. The FDA urges caution in dosage.

August 25, 2003|Jane E. Allen | Times Staff Writer

Patients who need help reducing their risk of heart attack and stroke now have one more cholesterol-lowering drug from which to choose.

Like other statins, Crestor (rosuvastatin) partially blocks the production of cholesterol in the liver. It lowers total cholesterol and low-density lipoprotein (LDL), or "bad" cholesterol, while increasing high-density lipoprotein (HDL), or "good" cholesterol. It also reduces triglycerides, another blood fat associated with the buildup of plaque in the arteries.

But the new drug is more potent than its predecessors. Although it could be particularly useful for people who aren't able to get their cholesterol under control with other statins, higher-than-recommended doses could increase the risk of potentially dangerous side effects, the FDA has warned.

"Having an additional statin will help us increase the use of the single most effective treatment there is to prevent atherosclerotic cardiovascular events and prolong life," said UCLA cardiologist Dr. Gregg C. Fonarow.

The six statins now available in the U.S. reduce cardiac risks among people with elevated cholesterol. They also can lower risks among people who have heart disease, diabetes or high blood pressure but normal cholesterol levels, Fonarow said.

But all statins have the potential to cause rhabdomyolysis, a dangerous and potentially fatal condition in which muscle cells break down, sometimes causing kidney damage and death. Although it's considered rare, anyone who experiences severe -- not just mild -- muscle pain or diffuse aches accompanied by fever or weakness should contact their doctor. Because this side effect occurred in clinical trials of patients taking an 80-milligram dose of Crestor, the FDA refused to approve that dosage.

The 80-milligram dose also caused some kidney problems, including some cases of protein or blood in the urine, leading the FDA to say patients taking Crestor could benefit from regular kidney monitoring during their routine medical appointments.

As with other statins, the FDA recommended that patients taking Crestor be tested for liver abnormalities before treatment and undergo periodic blood monitoring.

The other available statins are Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin), Pravachol (pravastatin) and Lescol (fluvastatin).

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