De JUPITER-studie over rosuvastatine en het risico op hart- en vaatziekten

The JUPITER trial, which compared rosuvastatin with placebo in 17,802 healthy subjects with normal cholesterol and elevated C reactive protein (CRP) levels, was reported in November 2008 at the American Heart Association meeting, and published at the same time in The New England Journal of Medicine. The results have been interpreted as proof that cholesterol-lowering reduces the risk of cardiovascular disease in the absence of an elevated cholesterol level in subjects at increased risk because of a high CRP level. Because follow-up did not extend beyond the primary endpoint (the combination of arterial revascularisation, unstable angina, myocardial infarction, stroke and cardiovascular death), the trial failed to document the entire incidence of major cardiovascular outcomes, and may have yielded distorted estimates of treatment effect. Evidence that the baseline cholesterol and CRP level were indeed related to the risk of the primary endpoint in the population studied was not presented. Evidence that lowering of either cholesterol level, or CRP level, or both, by rosuvastatin is related to risk reduction was not collected. Hence, the implications of the JUPITER trial remain unclear. There is no evidence that the effect of rosuvastatin observed in the JUPITER trial can be achieved with other statins as well.