Intensity of statin therapy in primary and secondary prevention

Template:Hypercholesterolemia Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kashish Goel, M.D.

Overview

The intensity of statin therapy is defined on the basis of the average expected LDL–C response to a specific statin and dose. “High-intensity,” “moderate-intensity,” and “lower-intensity” statin therapy definitions were derived from the systematic reviews for CQ1 and CQ2. The basis for differentiation among specific statins and doses arose from the RCTs included in CQ1, where there was a high level of evidence that high-intensity statin therapy with atorvastatin 40 mg to 80 mg reduced ASCVD risk more than moderate-intensity statin therapy with atorvastatin 10 mg, pravastatin 40 mg, or simvastatin 20 mg to 40 mg bid. Classifying specific statins and doses by the percent reduction in LDL–C level is based on evidence that the relative reduction in ASCVD risk from statin therapy is related to the degree by which

High- Moderate- and Low-Intensity Statin Therapy

High-Intensity Statin Therapy	Moderate-Intensity Statin Therapy	Low-Intensity Statin Therapy
Daily dose lowers LDL–C on average, by approximately ≥50%	Daily dose lowers LDL–C on average, by approximately 30% to <50%	Daily dose lowers LDL–C on average, by <30%
Atorvastatin (40†)–80 mg Rosuvastatin 20 (40) mg	Atorvastatin 10 (20) mg Rosuvastatin (5) 10 mg Simvastatin 20–40 mg‡ Pravastatin 40 (80) mg Lovastatin 40 mg Fluvastatin XL 80 mg Fluvastatin 40 mg bid Pitavastatin 2–4 mg	Simvastatin 10 mg Pravastatin 10–20 mg Lovastatin 20 mg Fluvastatin 20–40 mg Pitavastatin 1 mg

References

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