Crestor is associated with a higher rate of muscle and kidney complications than other cholesterol-lowering drugs, researchers report in a study published in the online edition of Circulation (published online May 23, www.circulationaha.org).

By analyzing postmarket adverse event reporting for four cholesterol-lowering drugs known as statins--AstraZeneca's Crestor, Pfizer's Lipitor, Merck's Zocor, and Bristol-Myers Squibb's Pravachol--physicians found that the side-effect rate for Crestor is more than double the rates for the other three drugs.

Crestor's side effects include muscle damage, protein in the urine, a reduced ability of the kidneys to filter toxins from the blood, and kidney failure. The absolute rate of adverse events, however, is low. During the first year of marketing, 145 muscle or kidney problems were associated with 5.2 million Crestor prescriptions.

The Food & Drug Administration, which in March rejected a petition from the watchdog group Public Citizen to ban Crestor, had no comment on the study. AstraZeneca says in a statement that it "stands fully behind the safety and effectiveness of Crestor when the product is used according to the prescribing information."

The authors of the Circulation article warn doctors that some patients may still need Crestor. "Several studies clearly show that statins reduce heart disease, stroke, and total mortality," says senior author Richard H. Karas, director of the Preventive Cardiology Center at Tufts-New England Medical Center. He recommends that Crestor, which is the strongest of the four statins, be given to patients whose cholesterol levels resist treatment with other statins.