In a head-to-head test of two popular cholesterol-lowering statin drugs — Lipitor and Crestor — both medications worked equally well.
Lipitor (atorvastatin) and Crestor (rosuvastatin) both effectively cleared away about 1% of artery-clogging plaque in heart patients after two years. Both drugs also lowered LDL, or “bad” cholesterol, and raised patients’ good HDL levels.
“There doesn’t seem to be a substantial difference between the two drugs,” Dr. Aaron Kesselheim, assistant professor of medicine at Harvard Medical School, told ABC News. Kesselheim was not involved in the current study.
So, how to choose? For many patients, it will likely come down to money: the blockbuster drug Lipitor is about to go generic. Brand-name statins can cost patients some $160 a month. But after the patent on Lipitor expires on Nov. 30, the availability of generic versions could drop its price by 80%.
The patent on Crestor — which goes for about $5 a pill — won’t expire until 2016. “The market for Crestor will go close to zero,” Dr. Cam Patterson, chief of cardiology at the University of North Carolina-Chapel Hill, predicted in an interview with USA Today.
The new study, led by Dr. Stephen Nicholls, clinical director of the Cleveland Clinic Center for Cardiovascular Diagnostics and Prevention, included more than 1,000 patients, average age 57, with coronary artery disease. Participants were randomly assigned to take high doses of either Lipitor (80 mg) or Crestor (40 mg) daily for two years.
By the end of the study, both groups had significant reductions in the fatty plaque lining their arteries, with few serious side effects. They also had fewer heart attacks, strokes and angioplasty procedures than would typically be seen in patients on less aggressive statin regimens. “Doctors have been reluctant to use high doses of statins, but in this study the drugs were safe, well tolerated and had a profound impact on lipid levels, the amount of plaque in vessel walls and the number of cardiovascular events,” said Nicholls in a statement.
On some measures, patients taking Crestor did better than those on Lipitor: LDL levels in the Crestor group dropped to an average 62.6 mg/dL, compared with 70.2 mg/dL for patients on Lipitor. Also, more patients taking Crestor (72%) than Lipitor (56%) saw their LDL levels fall below the 70 mg/dL target set for high-risk heart patients. Patients taking Crestor also had higher levels of good HDL.
Still, experts said the differences may not persuade many patients to switch to or stay on Crestor, known as the most potent of statins, given that Lipitor — the best-selling drug ever — will soon cost a lot less. The data, experts said, suggest that Lipitor and its generic versions will increase dominance of the market.
The new findings were reported Tuesday at the American Heart Association meeting in Orlando and published online by the New England Journal of Medicine.
Sora Song is the editor of TIME Healthland. Find her on Twitter at @sora_song. You can also continue the discussion on TIME Healthland’s Facebook page and on Twitter at @TIMEHealthland.