Comparative Lipid-Lowering/Increasing Efficacy of 7 Statins in Patients with Dyslipidemia, Cardiovascular Diseases, or Diabetes Mellitus: Systematic Review and Network Meta-Analyses of 50 Randomized Controlled Trials.

Published
May 16, 2020
Journal
Cardiovascular therapeutics
PICOID
66a0e63e
DOI
Citations
29
Keywords
Copyright
Copyright © 2020 Xiaodan Zhang et al.
Patients/Population/Participants

51956 participants

Intervention

7 different statins (simvastatin, fluvastatin, atorvastatin, rosuvastatin, lovastatin, pravastatin, and pitavastatin)

Comparison

comparing the lipid-lowering efficacy of no less than two of the included statins (or statin vs. placebo)

Outcome

LDL-C lowering

Abstract

P
I
C
O

The drug efficacy may differ among different statins, and evidence from head-to-head comparisons is sparse and inconsistent. The study is aimed at comparing the lipid-lowering/increasing effects of 7 different statins in patients with dyslipidemia, cardiovascular diseases, or diabetes mellitus by conducting systematic review and network meta-analyses (NMA) of the lipid changes after certain statins' use. In this study, we searched four electronic databases for randomized controlled trials (RCTs) published through February 25, 2020, comparing the lipid-lowering efficacy of no less than two of the included statins (or statin vs. placebo). Three reviewers independently extracted data in duplicate. Firstly, mixed treatment overall comparison analyses, in the form of frequentist NMAs, were conducted using STATA 15.0 software. Then, subgroup analyses were conducted according to different baseline diseases. At last, sensitivity analyses were conducted according to age and follow-up duration. The trial was registered with PROSPERO (number CRD42018108799). As a result, seven statin monotherapy treatments in 50 studies (51956 participants) were used for the analyses. The statins included simvastatin (SIM), fluvastatin (FLU), atorvastatin (ATO), rosuvastatin (ROS), lovastatin (LOV), pravastatin (PRA), and pitavastatin (PIT). In terms of LDL-C lowering, rosuvastatin ranked 1 According to the NMAs, it can be concluded that rosuvastatin ranked 1

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