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Intensive statin therapy may increase risk for new-onset diabetes
Preiss D. JAMA. 2011;305:2556-2564.
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An analysis of data from previously published studies revealed an increased risk for new-onset diabetes with intensive-dose statin therapy as compared with moderate-dose therapy.
Pooled results from five statin trials indicated that, of 32,752 participants without diabetes, 8.4% developed diabetes during a mean follow-up of about 5 years. Diabetes developed in 1,449 of those assigned to intensive-dose statin therapy and 1,300 assigned to moderate-dose therapy.
The researchers calculated an OR of 1.12 (95% CI, 1.04-1.22) for new-onset diabetes in patients who received intensive statin therapy vs. moderate therapy. Data also showed that two more cases of incident diabetes occurred per 1,000 patient-years among those who received intensive treatment (18.9) compared with those who received moderate therapy (16.9). Consequently, the researchers found that the number needed to harm was 498 per year for intensive therapy as compared with moderate therapy.
In contrast, intensive therapy conferred cardiovascular benefits. In those who received intensive therapy, 3,134 patients experienced CV events compared with 3,550 who received moderate therapy. Compared with moderate therapy, the researchers calculated an OR of 0.84 (95% CI, 0.75-0.94) for CV events in patients who received intensive therapy. Further, 6.5 fewer first major CV events occurred per 1,000 patient-years in the intensive-dose group (44.5) vs. the moderate-dose group (51). These results suggested that the number needed to treat to prevent one CV event per year was 155.
According to other results, the risk for incident diabetes was similar among patients who received an 80-mg dose of simvastatin (Zocor, Merck) and those who received an 80-mg dose of atorvastatin (Lipitor, Pfizer), although high-dose atorvastatin was associated with greater reductions in risk for CV events.
“Our findings suggest that clinicians should be vigilant for the development of diabetes in patients receiving intensive statin therapy,” the researchers concluded.
Disclosure: The researchers report receiving compensation from various companies.
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