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
Objective. 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 mel...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Cardiovascular Therapeutics |
| Online Access: | http://dx.doi.org/10.1155/2020/3987065 |
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| author | Xiaodan Zhang Lu Xing Xiaona Jia Xiaocong Pang Qian Xiang Xia Zhao Lingyue Ma Zhiyan Liu Kun Hu Zhe Wang Yimin Cui |
| author_facet | Xiaodan Zhang Lu Xing Xiaona Jia Xiaocong Pang Qian Xiang Xia Zhao Lingyue Ma Zhiyan Liu Kun Hu Zhe Wang Yimin Cui |
| author_sort | Xiaodan Zhang |
| collection | DOAJ |
| description | Objective. 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. Methods. 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). Results. 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 1st with a surface under cumulated ranking (SUCRA) value of 93.1%. The comparative treatment efficacy for LDL-C lowering was ROS>ATO>PIT>SIM>PRA>FLU>LOV>PLA. All of the other ranking and NMA results were reported in SUCRA plots and league tables. Conclusions. According to the NMAs, it can be concluded that rosuvastatin ranked 1st in LDL-C, ApoB-lowering efficacy and ApoA1-increasing efficacy. Lovastatin ranked 1st in TC- and TG-lowering efficacy, and fluvastatin ranked 1st in HDL-C-increasing efficacy. The results should be interpreted with caution due to some limitations in our review. However, they can provide references and evidence-based foundation for drug selection in both statin monotherapies and statin combination therapies. |
| format | Article |
| id | doaj-art-1c9298a939d34016939aab897ce139c2 |
| institution | Kabale University |
| issn | 1755-5914 1755-5922 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiovascular Therapeutics |
| spelling | doaj-art-1c9298a939d34016939aab897ce139c22025-02-03T00:59:41ZengWileyCardiovascular Therapeutics1755-59141755-59222020-01-01202010.1155/2020/39870653987065Comparative 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 TrialsXiaodan Zhang0Lu Xing1Xiaona Jia2Xiaocong Pang3Qian Xiang4Xia Zhao5Lingyue Ma6Zhiyan Liu7Kun Hu8Zhe Wang9Yimin Cui10Department of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaDepartment of Pharmacy, Base for Clinical Trial, Peking University First Hospital, Beijing 100034, ChinaObjective. 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. Methods. 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). Results. 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 1st with a surface under cumulated ranking (SUCRA) value of 93.1%. The comparative treatment efficacy for LDL-C lowering was ROS>ATO>PIT>SIM>PRA>FLU>LOV>PLA. All of the other ranking and NMA results were reported in SUCRA plots and league tables. Conclusions. According to the NMAs, it can be concluded that rosuvastatin ranked 1st in LDL-C, ApoB-lowering efficacy and ApoA1-increasing efficacy. Lovastatin ranked 1st in TC- and TG-lowering efficacy, and fluvastatin ranked 1st in HDL-C-increasing efficacy. The results should be interpreted with caution due to some limitations in our review. However, they can provide references and evidence-based foundation for drug selection in both statin monotherapies and statin combination therapies.http://dx.doi.org/10.1155/2020/3987065 |
| spellingShingle | Xiaodan Zhang Lu Xing Xiaona Jia Xiaocong Pang Qian Xiang Xia Zhao Lingyue Ma Zhiyan Liu Kun Hu Zhe Wang Yimin Cui 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 Cardiovascular Therapeutics |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| url | http://dx.doi.org/10.1155/2020/3987065 |
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