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Clinical Trial Results. org METEOR Trial Presented at the American College of Cardiology Annual Scientific Session March, 2007 Presented by Dr. John R.

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Presentation on theme: "Clinical Trial Results. org METEOR Trial Presented at the American College of Cardiology Annual Scientific Session March, 2007 Presented by Dr. John R."— Presentation transcript:

1 Clinical Trial Results. org METEOR Trial Presented at the American College of Cardiology Annual Scientific Session March, 2007 Presented by Dr. John R. Crouse III Measuring Effects of Intima-Media Thickness: An Evaluation of Rosuvastatin

2 Clinical Trial Results. org METEOR: Background Previous results from A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound [ASTEROID] illustrated that intensive lipid lowering with rosuvastatin over 24 months resulted in a significant regression of coronary atherosclerosis as measured by intravascular ultrasound.Previous results from A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound [ASTEROID] illustrated that intensive lipid lowering with rosuvastatin over 24 months resulted in a significant regression of coronary atherosclerosis as measured by intravascular ultrasound. However, ASTEROID was not a placebo controlled study and did not have clinical end points.However, ASTEROID was not a placebo controlled study and did not have clinical end points. Previous results from A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound [ASTEROID] illustrated that intensive lipid lowering with rosuvastatin over 24 months resulted in a significant regression of coronary atherosclerosis as measured by intravascular ultrasound.Previous results from A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound [ASTEROID] illustrated that intensive lipid lowering with rosuvastatin over 24 months resulted in a significant regression of coronary atherosclerosis as measured by intravascular ultrasound. However, ASTEROID was not a placebo controlled study and did not have clinical end points.However, ASTEROID was not a placebo controlled study and did not have clinical end points. ACC 2007

3 Clinical Trial Results. org METEOR: Background The goal of the present trial was to evaluate the effect of rosuvastatin compared with placebo on carotid intima-media thickness (CIMT) over 2 years among asymptomatic patients at low risk for cardiovascular disease.The goal of the present trial was to evaluate the effect of rosuvastatin compared with placebo on carotid intima-media thickness (CIMT) over 2 years among asymptomatic patients at low risk for cardiovascular disease. ACC 2007

4 Clinical Trial Results. org METEOR Trial: Study Design  Primary Endpoint: Annualized rate of change in maximum CIMT  Secondary Endpoint: Annualized rate of change in maximum CIMT derived from the near and far walls of the right and left common carotid artery; the right and left carotid bulb; the right and left internal carotid artery; and annualized rate of change in mean CIMT for the near and far walls of the right and left common carotid artery.  Primary Endpoint: Annualized rate of change in maximum CIMT  Secondary Endpoint: Annualized rate of change in maximum CIMT derived from the near and far walls of the right and left common carotid artery; the right and left carotid bulb; the right and left internal carotid artery; and annualized rate of change in mean CIMT for the near and far walls of the right and left common carotid artery. Rosuvastatin ( 40mg) n=702 n=702Placebon=282Placebon=282 984 asymptomatic patients with moderately elevated cholesterol and low risk of CVD according to the National Cholesterol Education Program Adult Treatment Panel III guidelines criteria (0-1 risk factor and LDL 120-190mg/dL or > 2 risk factors and LDL 120 to 2 risk factors and LDL 120 to <160mg/dL with a 10-year coronary heart disease risk < 10%); HDL-C <60mg/dL; triglycerides <500mg/dL; evidence of thickening of the walls of the extracranial carotid arteries as measured by B-mode ultrasound (max CIMT between 1.2 and <3.5mm) 5:2 Randomized. Double-blinded. Placebo-controlled. Mean age = 57 years. 40% Female. 984 asymptomatic patients with moderately elevated cholesterol and low risk of CVD according to the National Cholesterol Education Program Adult Treatment Panel III guidelines criteria (0-1 risk factor and LDL 120-190mg/dL or > 2 risk factors and LDL 120 to 2 risk factors and LDL 120 to <160mg/dL with a 10-year coronary heart disease risk < 10%); HDL-C <60mg/dL; triglycerides <500mg/dL; evidence of thickening of the walls of the extracranial carotid arteries as measured by B-mode ultrasound (max CIMT between 1.2 and <3.5mm) 5:2 Randomized. Double-blinded. Placebo-controlled. Mean age = 57 years. 40% Female. R 6, 12, 18 and 24 mos. follow-up ACC 2007

5 Clinical Trial Results. org After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in overall carotid segments, while the placebo group displayed progression (p<0.001).After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in overall carotid segments, while the placebo group displayed progression (p<0.001). Change in CIMT for 12 Carotid Artery sites (mm/year) Change in CIMT for 12 Carotid Artery sites (mm/year) METEOR Trial: Primary Endpoint n = 702 n = 282 p < 0.001 ACC 2007 Change in maximum CIMT with rosuvastatin vs. placebo Rosuvastatin Placebo

6 Clinical Trial Results. org After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in common carotid sites, while the placebo group displayed progression (p<0.001).After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in common carotid sites, while the placebo group displayed progression (p<0.001). Change in CIMT for common carotid sites (mm/year) Change in CIMT for common carotid sites (mm/year) METEOR Trial: Secondary Endpoint n = 702 n = 282 p < 0.001 ACC 2007 Change in maximum CIMT with rosuvastatin vs. placebo Rosuvastatin Placebo

7 Clinical Trial Results. org After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in carotid bulb sites, while the placebo group displayed progression (p<0.001).After two years, treatment with rosuvastatin was associated with a statistically significant reduction in the rate of progression of CIMT thickening in carotid bulb sites, while the placebo group displayed progression (p<0.001). Change in CIMT for carotid bulb sites (mm/year) Change in CIMT for carotid bulb sites (mm/year) METEOR Trial: Secondary Endpoint n = 702 n = 282 p < 0.001 ACC 2007 Change in maximum CIMT with rosuvastatin vs. placebo Rosuvastatin Placebo

8 Clinical Trial Results. org After two years, treatment with rosuvastatin was associated with a statistically significant lower progression in CIMT thickening in internal carotid sites as compared with the placebo group (p=0.02)After two years, treatment with rosuvastatin was associated with a statistically significant lower progression in CIMT thickening in internal carotid sites as compared with the placebo group (p=0.02) Change in CIMT for internal carotid artery sites (mm/year) Change in CIMT for internal carotid artery sites (mm/year) METEOR Trial: Secondary Endpoint n = 702 n = 282 p = 0.02 ACC 2007 Change in maximum CIMT with rosuvastatin vs. placebo RosuvastatinPlacebo

9 Clinical Trial Results. org METEOR Trial: Limitations The impact of aggressive lipid lowering on clinical events was not evaluated in this trial, particularly given the low-risk of the population.The impact of aggressive lipid lowering on clinical events was not evaluated in this trial, particularly given the low-risk of the population. The larger JUPITER trial will evaluate the impact of rosuvastatin therapy on clinical events in patients with low to normal levels of LDL but elevated levels of CRP.The larger JUPITER trial will evaluate the impact of rosuvastatin therapy on clinical events in patients with low to normal levels of LDL but elevated levels of CRP. The impact of aggressive lipid lowering on clinical events was not evaluated in this trial, particularly given the low-risk of the population.The impact of aggressive lipid lowering on clinical events was not evaluated in this trial, particularly given the low-risk of the population. The larger JUPITER trial will evaluate the impact of rosuvastatin therapy on clinical events in patients with low to normal levels of LDL but elevated levels of CRP.The larger JUPITER trial will evaluate the impact of rosuvastatin therapy on clinical events in patients with low to normal levels of LDL but elevated levels of CRP. ACC 2007

10 Clinical Trial Results. org METEOR Trial: Summary Among asymptomatic patients at low risk for cardiovascular disease, treatment with rosuvastatin was associated with a reduction in CIMT compared with placebo at 2 years.Among asymptomatic patients at low risk for cardiovascular disease, treatment with rosuvastatin was associated with a reduction in CIMT compared with placebo at 2 years. ACC 2007


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