(Statins) and Fixed-dose Combination Products Containing a Statin

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Final Report Update 5 Drug Effectiveness Review Project The medical literature relating to this topic is scanned periodically. (See http://www.ohsu.edu/ohsuedu/research/policycenter/DERP/about/methods.cfm for description of scanning process). Prior versions of this report can be accessed at the DERP website. Statins Page 2 of 128
Final Report Update 5 Drug Effectiveness Review Project TABLE OF CONTENTS INTRODUCTION ..........................................................................................................................7 Purpose and Limitations of Systematic Reviews.....................................................................................9 Scope and Key Questions .....................................................................................................................11 Inclusion Criteria ....................................................................................................................................13 METHODS ..................................................................................................................................14 Literature Search ...................................................................................................................................14 Study Selection ......................................................................................................................................14 Data Abstraction ....................................................................................................................................15 Validity Assessment...............................................................................................................................15 Data Synthesis.......................................................................................................................................15 Peer Review and Public Comment ........................................................................................................16 RESULTS ...................................................................................................................................16 Overview ................................................................................................................................................16 Report Organization...............................................................................................................................18 ADULTS .....................................................................................................................................18 Key Question 1. How do statins and fixed-dose combination products containing a statin and another lipid-lowering drug compare in their ability to reduce low-density lipoprotein cholesterol? ...................18 Summary of findings ......................................................................................................................18 Key Question 1a. Are there doses for each statin or fixed-dose combination product containing a statin and another lipid-lowering drug that produce similar percent reduction in low-density lipoprotein cholesterol?............................................................................................................................................18 Statins ............................................................................................................................................18 Fixed-dose combination products containing a statin and another lipid-lowering drug .................27 Key Question 1b. Do statins or fixed-dose combination products containing a statin and another lipidlowering drug differ in the ability to achieve National Cholesterol Education Program goals? .............28 Statins ............................................................................................................................................29 Fixed-dose combination products containing a statin and another lipid-lowering drug .................30 Key Question 2. How do statins and fixed-dose combination products containing a statin and another lipid-lowering drug compare in their ability to increase high-density lipoprotein cholesterol? ...............31 Summary of findings ......................................................................................................................31 Key Question 2a. Are there doses for each statin or fixed-dose combination product containing a statin and another lipid-lowering drug that produce similar percent increase in high-density lipoprotein cholesterol between statins? .................................................................................................................32 Statins ............................................................................................................................................32 Fixed-dose combination products containing a statin and another lipid-lowering drug .................33 Key Question 2b. Is there a difference in the ability of a statin or fixed-dose combination product containing a statin and another lipid-lowering drug to achieve National Cholesterol Education Panel goals?.....................................................................................................................................................34 Key Question 3. How do statins and fixed-dose combination products containing a statin and another lipid-lowering drug compare in their ability to reduce the risk of nonfatal myocardial infarction, coronary heart disease (angina), coronary heart disease mortality, all-cause mortality, stroke, hospitalization for unstable angina, or need for revascularization (coronary artery bypass graft, angioplasty, or stenting)? ...............................................................................................................................................35 Summary of findings ......................................................................................................................35 Detailed assessment......................................................................................................................36 Key Question 4. Are there differences in effectiveness of statins and fixed-dose combination products containing a statin and another lipid-lowering drug in different demographic groups or in patients with comorbid conditions (e.g., diabetes, obesity)? ......................................................................................56 Summary of findings ......................................................................................................................56 Statins Page 3 of 128
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(Statins) and Fixed-dose Combination Products Containing a Statin

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