Efficacy and Safety of Alternate-Day Versus Daily Dosing of Statins: a Systematic Review and Meta-Analysis

On Behalf Of The Lipid And Blood Pressure Meta-Analysis Collaboration (Lbpmc) Group

Research output: Contribution to journalArticle

Abstract

Purpose: We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs to synthesize evidence about the efficacy and safety of alternate-day vs daily dosing of statins. Methods: We searched selected databases through January 2, 2017 to identify relevant RCTs and quasi-RCTs. The primary outcome was change in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), while secondary outcomes included adverse events and adherence. Results: Twelve RCTs and 1 quasi-RCT (n = 1023 patients) were included in the analysis. Pooled analysis revealed no statistically significant difference between alternate-day and daily regimens of atorvastatin and rosuvastatin in terms of change in LDL-C (mean difference [MD] 6.79 mg/dL, 95% confidence interval [CI] −1.59, 15.17, p = 0.11, and 10.51 mg/dL, 95%CI −0.23, 21.26, p = 0.06, respectively) and TG (p > 0.05). Daily regimens of atorvastatin and rosuvastatin were superior to alternate-day regimes in term of change in TC (MD 12.45 mg/L, 95%CI 8.14, 16.76, p < 0.00001, and 15.80 mg/dL, 95%CI 5.66, 25.95, p = 0.002, respectively). For all outcomes, there was no statistically significant difference between alternate-day and daily regimens for both fluvastatin and pravastatin (p > 0.05). Both regimens of statins were generally well tolerated with good adherence. Conclusions: Alternate-day dosing of individual statins (especially atorvastatin and rosuvastatin) is as efficacious as daily dosing on LDL-C and TG.

Original languageEnglish (US)
Pages (from-to)1-13
Number of pages13
JournalCardiovascular Drugs and Therapy
DOIs
StateAccepted/In press - Jul 24 2017

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Meta-Analysis
Randomized Controlled Trials
Safety
LDL Cholesterol
Confidence Intervals
Triglycerides
Cholesterol
Databases
Rosuvastatin Calcium
Atorvastatin Calcium

Keywords

  • Cholesterol
  • LDL cholesterol
  • Lipids
  • Lipoproteins
  • Statins

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

Cite this

Efficacy and Safety of Alternate-Day Versus Daily Dosing of Statins : a Systematic Review and Meta-Analysis. / On Behalf Of The Lipid And Blood Pressure Meta-Analysis Collaboration (Lbpmc) Group.

In: Cardiovascular Drugs and Therapy, 24.07.2017, p. 1-13.

Research output: Contribution to journalArticle

On Behalf Of The Lipid And Blood Pressure Meta-Analysis Collaboration (Lbpmc) Group. / Efficacy and Safety of Alternate-Day Versus Daily Dosing of Statins : a Systematic Review and Meta-Analysis. In: Cardiovascular Drugs and Therapy. 2017 ; pp. 1-13.
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T1 - Efficacy and Safety of Alternate-Day Versus Daily Dosing of Statins

T2 - a Systematic Review and Meta-Analysis

AU - On Behalf Of The Lipid And Blood Pressure Meta-Analysis Collaboration (Lbpmc) Group

AU - Awad, Kamal

AU - Mikhailidis, Dimitri P.

AU - Toth, Peter P.

AU - Jones, Steven

AU - Moriarty, Patrick

AU - Lip, Gregory Y.H.

AU - Muntner, Paul

AU - Catapano, Alberico L.

AU - Pencina, Michael J.

AU - Rosenson, Robert S.

AU - Rysz, Jacek

AU - Banach, Maciej

PY - 2017/7/24

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N2 - Purpose: We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs to synthesize evidence about the efficacy and safety of alternate-day vs daily dosing of statins. Methods: We searched selected databases through January 2, 2017 to identify relevant RCTs and quasi-RCTs. The primary outcome was change in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), while secondary outcomes included adverse events and adherence. Results: Twelve RCTs and 1 quasi-RCT (n = 1023 patients) were included in the analysis. Pooled analysis revealed no statistically significant difference between alternate-day and daily regimens of atorvastatin and rosuvastatin in terms of change in LDL-C (mean difference [MD] 6.79 mg/dL, 95% confidence interval [CI] −1.59, 15.17, p = 0.11, and 10.51 mg/dL, 95%CI −0.23, 21.26, p = 0.06, respectively) and TG (p > 0.05). Daily regimens of atorvastatin and rosuvastatin were superior to alternate-day regimes in term of change in TC (MD 12.45 mg/L, 95%CI 8.14, 16.76, p < 0.00001, and 15.80 mg/dL, 95%CI 5.66, 25.95, p = 0.002, respectively). For all outcomes, there was no statistically significant difference between alternate-day and daily regimens for both fluvastatin and pravastatin (p > 0.05). Both regimens of statins were generally well tolerated with good adherence. Conclusions: Alternate-day dosing of individual statins (especially atorvastatin and rosuvastatin) is as efficacious as daily dosing on LDL-C and TG.

AB - Purpose: We conducted a meta-analysis of randomized controlled trials (RCTs) and quasi-RCTs to synthesize evidence about the efficacy and safety of alternate-day vs daily dosing of statins. Methods: We searched selected databases through January 2, 2017 to identify relevant RCTs and quasi-RCTs. The primary outcome was change in low-density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG), while secondary outcomes included adverse events and adherence. Results: Twelve RCTs and 1 quasi-RCT (n = 1023 patients) were included in the analysis. Pooled analysis revealed no statistically significant difference between alternate-day and daily regimens of atorvastatin and rosuvastatin in terms of change in LDL-C (mean difference [MD] 6.79 mg/dL, 95% confidence interval [CI] −1.59, 15.17, p = 0.11, and 10.51 mg/dL, 95%CI −0.23, 21.26, p = 0.06, respectively) and TG (p > 0.05). Daily regimens of atorvastatin and rosuvastatin were superior to alternate-day regimes in term of change in TC (MD 12.45 mg/L, 95%CI 8.14, 16.76, p < 0.00001, and 15.80 mg/dL, 95%CI 5.66, 25.95, p = 0.002, respectively). For all outcomes, there was no statistically significant difference between alternate-day and daily regimens for both fluvastatin and pravastatin (p > 0.05). Both regimens of statins were generally well tolerated with good adherence. Conclusions: Alternate-day dosing of individual statins (especially atorvastatin and rosuvastatin) is as efficacious as daily dosing on LDL-C and TG.

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KW - LDL cholesterol

KW - Lipids

KW - Lipoproteins

KW - Statins

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