Abstract: AIM: In this study, we assessed the safety and efficacy of generic and branded atorvastatin in patients with ischemic stroke/transient ischemic attack in real-world practice.  METHODS: Patients admitted for ischemic stroke/transient ischemic attack between January 1, 2018 and March 31, 2021 who continually received atorvastatin for ≥6 months after diagnosis were included. Safety and efficacy endpoints in patients receiving the generic atorvastatin were compared with those of patients receiving the branded medication. Propensity score matching was applied to control confounders. RESULTS: There were 665 patients in our final analysis, 302 in the branded group and 363 in the generic group. After propensity score matching, patients who received generic atorvastatin did not show a greater incidence of Ischemic Stroke/transient ischemic attack recurrence or onset of coronary heart disease. Similar changes in NIHSS and mRS scores were observed between the generic and branded groups. Consistent results were found in rates of hepatobiliary laboratory abnormalities and the compound adverse event profile of an elevated creatine kinase level, elevated aspartate aminotransferase/alanine aminotransferase levels, and intracranial hemorrhage. Results were consistent before and after propensity score matching. CONCLUSION: Both generic and branded atorvastatin are equally effective in preventing stroke recurrence and improving neurological deficits in patients with ischemic stroke/transient ischemic attack. Both treatments are generally well tolerated by patients.

Key words: atorvastatin, ischemic stroke, transient ischemic attack, efficacy, safety