The JUPITER Trial: What it Could Mean to Your Life
  Contributed by: Megan Wiggers, Pharm.D.
                        Community Pharmacy Resident

What if you could decrease your risk of heart attack or stroke by nearly 50 percent?  A recent study suggests that the cholesterol lowering drug, Crestor, can potentially do just that.

What is Crestor?  How does it work?
Crestor, generically know as rosuvastatin, is the newest member of a class of cholesterol lowering medications called "statins".  The statins work to lower cholesterol by preventing the formation of cholesterol in the liver.  Crestor is a prescription only medication.  Side effects include liver dysfunction, muscle pain,

Why is lowering cholesterol important?
Although cholesterol is an important part of the human body, high levels can be detrimental.  Cholesterol and other substances can accumulate as plaque in the walls of arteries, a process also known as atherosclerosis.  The unstable cholesterol laden plaque can easily develop a blood clot that can block blood flow to a vital organ such as the heart or brain.  This is commonly known as a heart attack or stroke.

Important definitions:
Low-density-lipoprotein (LDL):  LDL is known as the "bad cholesterol".  Excessive LDL levels can be responsible for heart attacks and strokes, etc.  Normal levels are less than 130mg/dl.   

High-density-lipoprotein (HDL):  HDL is known as the "good cholesterol".  HDL acts as the "scavenger" by picking up LDL and transporting it to the liver for destruction.  Normal levels are greater than 40mg/dl (men) and 50mg/dl (women). 
C-Reactive Protein (CRP):  CRP is a protein that increases during inflammation.  An elevated CRP level could be caused by allergies, recent surgery, or heart disease, etc.  CRP is often used to assess an individual's cardiovascular risk.  Normal levels are less than 1mg/L.

Understanding the JUPITER trial?   
What: Justification for the Use of Statins in Primary Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER).
Why: To determine if Crestor decreased the rate of heart attack or stroke in patients with low to normal cholesterol. 
When: The trial started February 2003.  The trial was forced to stop in March 2008 due to overwhelmingly positive results. 
Who: Around 15,000 men over 50 and women over 60 years of age who did not have evidence of cardiovascular disease participated in the study.  All trial participants had an LDL cholesterol less than 130mg/dl and a CRP level greater than 2mg/L. 
Where: The trial took place in 48 US states and over 25 different countries.
How: Participants took either

Crestor 20mg or placebo once daily.
Results for participants taking Crestor:

  • The combined risk of death from heart attack or stroke was reduced by 47%.
  • The risk of heart attack was reduced by 54%.
  • The risk of stroke was reduced by 48%.
  • The total mortality was significantly reduced by 20%.

Disclaimer
: Crestor is not indicated for the prevention of cardiovascular events. Crestor should be used according to the prescribing information, which contains recommendations for initiating and titrating therapy according to the individual patient profile.

For more information, please visit www.americanheart.org, www.webmd.com, or www.astrazeneca-us.com.  As always, please contact your physician or local pharmacist for further questions.   

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