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New EXPLORER Results Show Patients Achieved Dramatic Reductions in C-Reactive Protein And LDL-C Levels With CRESTOR Combination Therapy.


LONDON -- A combination treatment regimen of CRESTOR(TM) (rosuvastatin) 40 mg and ezetimibe 10 mg demonstrated a 46% reduction in levels of C-reactive protein C-Reactive Protein Definition

C-reactive protein (CRP) is a protein produced by the liver and found in the blood.
Purpose

C-reactive protein is not normally found in the blood of healthy people.
 (CRP C-reactive protein (CRP)
A protein present in blood serum in various abnormal states, like inflammation.

Mentioned in: Pelvic Inflammatory Disease

CRP,
n.pr See C-reactive protein.
), a marker of inflammation and risk factor for cardiovascular disease Cardiovascular disease
Disease that affects the heart and blood vessels.

Mentioned in: Lipoproteins Test

cardiovascular disease 
, in high-risk patients. In just six weeks, the combination regimen also helped more than half (58%) of patients achieve dual CRP/LDL-C goals.(1) These post-hoc analysis findings from the EXPLORER(a) study will be presented for the first time this week at the World Congress of Cardiology in Barcelona. Previous EXPLORER results released at ISA (1) (Instruction Set Architecture) See instruction set.

(2) (Interactive Services Association) See Internet Alliance.

(3) (Internet Security and Acceleration) See .NET.
 in June showed high-risk patients achieved an unprecedented 70% reduction in LDL-C LDL-C low-density-lipoprotein cholesterol  using CRESTOR combination therapy.(2)

"Physicians have long relied on blood cholesterol as a key indicator of cardiovascular risk, but recent research suggests that adding a CRP goal to existing LDL-C targets could potentially further reduce the risk of cardiovascular outcomes," said lead investigator Professor Christie Ballantyne, director of the Center for Cardiovascular Disease Prevention at the Methodist DeBakey Heart Center and professor at Baylor College of Medicine Baylor College of Medicine is a private medical school located in Houston, Texas, USA on the grounds of the Texas Medical Center. It has been consistently rated the top medical school in Texas and among the best in the United States. , Houston, USA. "Although additional studies are still needed, EXPLORER suggests that a treatment regimen using CRESTOR and ezetimibe can help patients not only to achieve optimal cholesterol targets, but also to significantly reduce their levels of CRP."

Previous clinical trials have demonstrated limited success in achieving dual CRP/LDL-C goals(3), particularly for high-risk patients in whom target levels are CRP <2 mg/L combined with LDL-C <100 mg/dL or LDL-C <70 mg/dL (depending on risk category). The significant reductions in both markers seen in the EXPLORER study provide a new opportunity for high-risk patients to potentially reduce their cardiovascular risks with combination therapy.

Inflammation of the blood vessels Blood vessels

Tubular channels for blood transport, of which there are three principal types: arteries, capillaries, and veins. Only the larger arteries and veins in the body bear distinct names.
 and arteries can lead to serious complications such as heart attack and stroke(4), and high levels of CRP can predict these risks years before they actually occur. The first outcomes study to examine the effect of statins Statins
A class of drugs commonly used to lower LDL cholesterol levels.

Mentioned in: C-Reactive Protein
 on cardiovascular morbidity and mortality Morbidity and Mortality can refer to:
  • Morbidity & Mortality, a term used in medicine
  • Morbidity and Mortality Weekly Report, a medical publication
See also
  • Morbidity, a medical term
  • Mortality, a medical term
 among individuals with normal to low cholesterol levels and elevated CRP is currently under way. The objective of the study, known as JUPITER (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin), is to determine whether long-term treatment with CRESTOR will reduce the risk for cardiovascular events in this patient population. CRESTOR already has been shown to be the most effective statin stat·in
n.
Any of a class of drugs that inhibit a key enzyme involved in the synthesis of cholesterol and promote receptor binding of LDL cholesterol, resulting in decreased levels of serum cholesterol.
 at reducing LDL-C,(5-24) enabling most patients with high cholesterol to successfully achieve their guideline LDL-C goal.

Key findings from EXPLORER:(1,25)

--Significantly more patients (58% vs. 24%) achieved dual LDL-C/CRP goals of LDL-C <100 mg/dL or <70 mg/dL (depending on risk category) and CRP <2 mg/L at six weeks with CRESTOR 40mg and ezetimibe 10mg compared with CRESTOR monotherapy.

--CRESTOR and ezetimibe reduced CRP levels by 46% compared with just 29% with CRESTOR monotherapy.

--CRESTOR and ezetimibe also reduced mean LDL-C by an unprecedented 70%.

--Significantly (p<0.001) more patients achieved their NCEP NCEP National Cholesterol Education Program  ATP ATP: see adenosine triphosphate.
ATP
 in full adenosine triphosphate

Organic compound, substrate in many enzyme-catalyzed reactions (see catalysis) in the cells of animals, plants, and microorganisms.
 III LDL-C goal of <100 mg/dL (94% vs 79%) and their European LDL-C goal (94% vs. 74%) at six weeks with CRESTOR and ezetimibe compared with CRESTOR monotherapy.

--Both CRESTOR monotherapy and CRESTOR combined with ezetimibe produced similar increases in HDL-C HDL-C high-density-lipoprotein cholesterol.  ("good" cholesterol) (8.5%vs. 10.8%).

--CRESTOR and ezetimibe were both well tolerated.

The results from EXPLORER add to the outstanding CRESTOR efficacy data from its extensive GALAXY clinical trials programme, designed to address important unanswered questions in statin research and to investigate the impact of CRESTOR on cardiovascular risk reduction and patient outcomes. Currently, more than 51,000 patients have been recruited from 55 countries worldwide to participate in the GALAXY Programme.

CRESTOR has now received regulatory approvals in more than 75 countries across five continents. Over seven million patients have been prescribed CRESTOR worldwide, and from clinical trials, marketed use, the recently published National Lipid Association safety evaluation, and early pharmacoepidemiology data, the safety profile is in line with other marketed statins.

The 40 mg dose is the highest registered dose of CRESTOR. CRESTOR should be used according to the prescribing information, which contains recommendations for initiating and titrating therapy according to the individual patient profile. In most countries, the usual recommended starting dose of CRESTOR is 5 or 10mg.

For further information please visit: www.AstraZenecaPressOffice.com.

Notes to Editors:

EXPLORER was a 12-week, randomised Adj. 1. randomised - set up or distributed in a deliberately random way
randomized

irregular - contrary to rule or accepted order or general practice; "irregular hiring practices"
 trial of 469 patients with LDL-C 160-<250 mg/dL (4.1-<6.5 mmol/L) designed to evaluate whether adding ezetimibe to CRESTOR would enable more patients with severely high cholesterol to achieve guideline lipid goals compared with CRESTOR monotherapy. Patients participated in a six-week dietary lead-in followed by six weeks of randomised treatment with rosuvastatin 40 mg alone or in combination with ezetimibe 10 mg.

References:

(a) EXPLORER (Examination of Potential Lipid modifying effects Of Rosuvastatin in combination with Ezetimibe versus Rosuvastatin alone)

1. Ballantyne C, Sosef F, Duffield E. Rosuvastatin Plus Ezetimibe for Achievement of Low-Density Lipoprotein Cholesterol low-density lipoprotein cholesterol (lōˈ-denˑ·s  and C-Reactive Protein Goals: Results From the EXPLORER Study. Poster presented at: World Congress of Cardiology; 6 September, 2006; Barcelona, Spain.

2. Ballantyne C, Sosef F, Duffield E. Efficacy and Safety of Rosuvastatin Plus Ezetimibe in High-Risk Patients: Results from the EXPLORER Study. Paper presented at: International Symposium on Atherosclerosis; 22 June, 2006; Rome, Italy.

3. Ridker PM et. al. for the Pravastatin pravastatin /prav·a·stat·in/ (prav´ah-stat?in) an antihyperlipidemic agent that acts by inhibiting cholesterol synthesis, used as the sodium salt in the treatment of hypercholesterolemia and other forms of dyslipidemia and to lower the  or Atorvastatin atorvastatin /ator·va·stat·in/ (ah-tor?vah-stat´in) an antihyperlipidemic agent that acts by inhibiting cholesterol synthesis, used as the calcium salt in the treatment of hypercholesterolemia and other forms of dyslipidemia.  Evaluation and Infection Therapy - Thrombolysis in Myocardial Infarction Thrombolysis In Myocardial Infarction (TIMI) is a large randomized controlled trial into myocardial infarction (heart attacks) and the use of thrombolysis. External links
  • Official site
 22 (PROVE IT-TIMI 22) Investigators. C-Reactive Protein Levels and Outcomes after Statin Therapy. N Engl J Med 2005;352:20-8.

4. American Heart Association American Heart Association (AHA),
n.pr a national voluntary health agency that has the goal of increasing public and medical awareness of cardiovascular diseases and stroke, and thereby reducing the number of associated deaths and disabilities.
. "Atherosclerosis." 2004. Available: http://www.americanheart.org/presenter.jhtml?identifier=4440

5. Jones PH , Davidson MH, Stein EA et al. Am J Cardiol 2003;92:152-160.

6. Schuster H, Barter P, Stender S et al. Am Heart J 2004;147:705-712.

7. Blasetto JW, Stein EA, Brown WV et al. Am J Cardiol 2003;91(Suppl):3C-10C.

8. Berne C, Siewart-Delle A. Cardiovascular Diabetology 2005; 4:7

9. Betteridge JD, Gibson M. Atheroscler Suppl 2004;5(1):107, Abs M464.

10. Davidson M, Ma P, Stein EA et al. Am J Cardiol 2002;89:268-275.

11. Schwartz GG, Bolognese MA, Tremblay BP et al. Am Heart J 2004;148(1):P105, H1-H9.

12. Olsson AG, Istad H, Luurila O et al. Am Heart J 2002;144:1044-1051.

13. Stalenhoef A, Ballantyne C, Sarti C et al. Eur Heart J 2005;26:2664-2672.

14. Strandberg TE, Freely J, Sigurdsson E. Clin Ther 2004;26(11):1821-1833.

15. Gupta M, Constance C. Atheroscler Suppl 2005;6(1):108-109 Abs W16-P-033.

16. Fonseca FAH, Marotti M et al. Current Medical Research and Opinion 2005;21 (8):1307-1315.

17. Jukema J, Liem A, Dunselman P et al. Current Medical Research and Opinion 2005;21(11):1864-1876.

18. Clearfield M, Kallend D, Palmer M et al. Atheroscler Suppl 2005;6(1):104 Abs W16-P-014.

19. Wolffenbuttel B, Franken A, Vincent H et al. J Int Med 2005;257:531-539.

20. Paoletti R, Fahmy M, Mahla G et al. J Cardiovasc Risk 2001;8:383-390.

21. Brown W, Bays HE, Hassman DR et al. Am Heart J 2002;144:1036-1043.

22. Stein E, Strutt KL, Miller E, Southworth H. Am J Cardiol 2003;92:1287-1293.

23. Schneck DW, Knopp RH, Ballantyne CM et al. Am J Cardiol 2003;91:33-41.

24. Leiter LA, Palmer M, Kallend D et al. Atheroscler Suppl 2005;6(1):113 Abs W16-P-051.

25. Ballantyne C, Sosef F, Duffield E. Efficacy and Safety of Rosuvastatin Plus Ezetimibe in High-Risk Patients: Results from the EXPLORER Study. Atherosclerosis Supplements 2006;7(3):552 Abs Th-P16:270.
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Date:Sep 6, 2006
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