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Colesevelam remained effective, despite statin use
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PHILADELPHIA — In a post-hoc analysis, colesevelam significantly reduced HbA1c and LDL levels in adults with type 2 diabetes, regardless of statin use, when compared with placebo, according to data presented here at the American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress Meeting.
In a previous 26-week study of adults with type 2 diabetes on metformin-based therapy, researchers randomly assigned 159 patients with HbA1c levels ranging from 7.5% to 9.5% to 3.75 g colesevelam hydrochloride (Welchol, Daiichi Sankyo) daily or placebo. Results favored colesevelam, with an average treatment difference of –15.9% (P<.001). Thirty-nine percent of colesevelam patients and 42% of placebo patients initiated statin therapy before enrollment and continued throughout the study.
“It’s the only lipid altering drug that has an additional indicated use to lower glucose levels,” Harold Bays, MD, medical director and president of the Louisville Metabolic and Atherosclerosis Research Center in Kentucky, said during a presentation.
Bays reported that colesevelam decreased HbA1c more than placebo in statin users (P=.0003) and non-users (P=.001). Statin users, compared with non-users on colesevelam, experienced an 11.7% reduction in non-HDL; a –8.5% reduction in total cholesterol and a –0.1% reduction in apolipoproteins B/A1, with no change in HDL and apolipoprotein A1 levels, he said.
“There’s nothing in this data that suggests being on a statin impairs the effectiveness of colesevelam in patients on statin therapy,” Bays concluded.
For more information:
- Bays H. Abstract #1304. Presented at: the American Association of Clinical Endocrinologists 21st Annual Scientific and Clinical Congress Meeting; May 23-27, 2012; Philadelphia.
Disclosure: Waiting on relevant financial disclosures.
Perspective
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Alan J. Garber, MD, PhD
It turns out that colesevelam has independent and significant glucose-lowering effects equivalent to other recently approved antidiabetic drugs. It’s reassuring to those of us who treat patients with combined disease that you can still get action on both targets.
Wherever possible, you want to try and use as few medications as you can. Patients with diabetes are taking so many medications and we know that the more medicines you prescribe for a patient, the less likely they are to adhere to the prescriptions for a variety of reasons. When you can use a lesser number of medications to treat the patients with diabetes and multiple risk factors, this is a useful observation and eliminates a potential concern regarding a medicine often used in conjunction with colesevelam.
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