Can rosuvastatin save the world?

Ever since I was young, I have always loved astronomy. I would memorize all the nine planets, the names of their moons, their distance from the earth, and other peculiar details. My vocabulary was filled with words like meteor, asteroid, comet, and universe.

Thus, when I recently came across the worldwide trials being conducted by AstraZeneca for their blockbuster drug rosuvastatin (brand name Crestor), these childhood terms I loved came back.

In the treatment of high cholesterol and heart disease, AstraZeneca has launched an ambitious effort to find the real standing of their superdrug rosuvastatin. AstraZeneca’s huge campaign includes 23 clinical studies for rosuvastatin, enrolling 69,000 subjects in more than 55 countries around the world.

Under AstraZeneca’s unique galaxy program, each clinical trial will be named after some heavenly body. Currently, 14 of 23 studies have been completed. These are Comet, Corona, Discovery, Mercury 1, Mercury 2, Meteor, Orbital, Pulsar, Polaris, Stellar, Orion, Eclipse, Explorer, and Asteroid.

You might wonder what all these terms mean. Why does a company need to spend billions in order to prove the efficacy and safety of one drug for cholesterol problems? Well, that is how medical science works. A good, unbiased scientific trial is the only way we can know for sure if a drug or supplement is effective or not. Simple testimonies, anecdotal reports, and celebrity endorsements are not sufficient.

METEOR Trial: Rosuvastatin Cleans the Neck Arteries

In the Meteor study (JAMA, 3-28-07), lead investigator Dr. John Crouse, professor of endocrinology at Wake Forest University School of Medicine in North Carolina, showed that patients given rosuvastatin had slower buildup of cholesterol plaques in the neck arteries, compared to patients taking placebo. The bad cholesterol level went down, and the good cholesterol went up with rosuvastatin.

So what, you might ask? Well, less plaque in the arteries means less obstruction to blood flow. Therefore, possibly saving you from a stroke or heart attack.

ASTEROID Trial: Rosuvastatin Cleans the Heart Arteries

In this two-year study (Circulation, 3-31-08), researchers looked at the effect of rosuvastatin in the buildup of cholesterol in the arteries of the heart. Just so you know, blockage of these arteries may lead to an angioplasty or a heart bypass. Again, the results positively showed that rosuvastatin was very effective in reducing fat buildup in the heart arteries. On the average, bad cholesterol was reduced by an astounding 53 percent and good cholesterol was increased by 15 percent.

CORONA Trial: Effect on Heart Failure Patients

Unlike the above two studies, the results of the Corona study was a bit neutral (New England Journal of Medicine, 11-29-07). Rosuvastatin did not worsen the condition of patients with heart failure, although the drug did prevent a lot of patients from getting hospitalized. This means that doctors may or may not give statins for patients with heart failure. At least, the Corona trial tells us that.

JUPITER Trial: Rosuvastatin for Healthy Patients?

Just like the heavyweight planet, the Jupiter trial offers the best evidence doctors have on the benefits of taking rosuvastatin. With over 17,000 patients tested in 26 countries, the Jupiter trial will determine if rosuvastatin can prolong the lives of patients with normal cholesterol levels. However, these patients had a high C-reactive protein (CRP) level, which is a new test for heart disease.

Well, imagine my surprise when, on March 31, 2008, AstraZeneca stopped the Crestor-Jupiter study prematurely because of very positive results! I heard that the patients on Crestor lived longer (less heart attacks), compared to those on placebo. The expected earthshaking report will soon follow. Stay tuned.

Giving Statins For Other Conditions

I admire AstraZeneca for their confidence in trying rosuvastatin for other medical conditions. For example, in the ongoing Aurora study, we will find out if rosuvastatin can help patients with kidney failure undergoing dialysis. Wow! If this study turns out positive, then all patients with kidney problems may benefit from rosuvastatin.

There is also a curious study called Pluto, the farthest planet in our solar system. In Pluto, researchers are thinking of giving rosuvastatin to children with genetically high levels of cholesterol. It has nothing to do with their diet, but these kids have cholesterols levels of over 400 mg/dl. This study just shows how far researchers are trying to advance medical science.

Since AstraZeneca is confident in its product’s abilities, it has pitted rosuvastatin head-on against atorvastatin (another excellent statin drug). The battle of the statins fall under the acronym of Saturn, the ringed planet. When the results of Saturn come out, we will know with greater certainty which is the better drug — rosuvastatin or atorvastatin? As a boxing fan, it’s like Manny Pacquiao fighting everybody from flyweight to welterweight to see his real standing among the top fighters.        

Which Drug To Take?

Right now, the two top statins on the market are atorvastatin (Lipitor) and simvastatin (Vidastat, Zocor). But rosuvastatin (Crestor) does not want to be left behind. A spokesperson for AstraZeneca’s Research was quoted as saying, “The other statins have already established their place in the patients’ conditions. Crestor differs in that it can lower the cholesterol levels much better than the other drugs. With the Galaxy studies, we want to show that Crestor can be of help to many other patients, too.”

I must admit that I found rosuvastatin too expensive at P70 per 10 mg. tablet and, thus, rarely prescribed it. However, with the discount cards, the price has gone down to P43 per tablet. And with my inclination for splitting tablets in half, this can go down to P21.50 per day in selected patients.

Can Crestor conquer the world? With their galaxy program and use of the heavenly bodies, AstraZeneca sure hopes it can.

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Kidney Friends’ concert

Dr. Albert T. Chua, past president of the Philippine Society of Nephrology, invites everyone to watch a fundraising concert for patients with kidney diseases. The concert is called “Kidney Friends nAPO Sila” featuring the APO Hiking Society with special guest Kyla, on June 9 at the Music Museum. According to Kidney Friends president Dr. Benita Padilla, “The proceeds will go to teaching livelihood programs to kidney patients so they can become self-sufficient in their medical needs.“

If you are interested to be a kidney friend, call 632-994-7879 or e-mail kidneyfriends@yahoo.com.

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E-mail questions to drwillieong@gmail.com.