Rosuvastatin을 중심으로 본 HMG-CoA Reductase Inhibitor간 처방 변경 사유의 분석에 관한 연구
The factors influencing medication change among the HMG-CoA Reductase inhibitors focusing on Rosuvastatin
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Abstract
Rosuvastatin is the latest developed HMG-CoA reductase inhibitor. It has the most potent lipid-lowering effect and its cost is comparatively high with atorvastatin. In Seoul National University Hospital(SNUH), the number of its prescription has been increasing monthly since the introduction on February 2005. In spite of rosuvastatin’s strong lipid-lowering effect, physicians sometimes change the antilipidemic medication from rosuvastatin to another HMGCoA reductase inhibitor. Focusing on rosuvastatin, we tried to find out the reasons why the medical physicians changed the prescription of the antilipidemic drug. And we evaluated whether the antilipidemic pharmacotherapy was accomplished effectively and safely. In this study, we investigated the cases of the antilipidemic medication conversion in SNUH between March 1, 2005 and March 31, 2006. We reviewed the medical records and the laboratory data of the patients retrospectively. 296 cases were changed from one of the HMG-CoA reductase inhibitors to rosuvastatin. 165 cases(55.7%) of them were changed in order to achieve rapid-lipid lowering effect and 4 cases(1.4%) of them were changed to avoid adverse drug reactions and to obtain safe pharmacotherapy. In 127 cases(42.9%), we could not find out the factors influencing the medication change. On the other hand, the total number of cases to change one of the other HMG-CoA reductase inhibitors from rosuvastatin was 65. In the 11 cases(55.7%), the patients were refractory to rosuvastatin, so the antilipidemic medication were changed. 21 cases(32.3%) of them were changed to avoid adverse drug reactions and to obtain safe pharmacotherapy. In the 7 cases(10.8%), the patient’s LDL-C level was reached within the target LDL-C range according to National Cholesterol Education Program. Of the remaining 26 cases, we could not figure out the reasons why the physicians changed the antilipidemic medication. It is necessary to follow up the patients in order to evaluate whether the purpose of the medication change will be obtained.
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