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Livalo lowers HbA1c in poorly controlled diabetes
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Taiwanese adults with poorly controlled type 2 diabetes who were statin-naive or prescribed atorvastatin for dyslipidemia saw a reduction in HbA1c when adding or switching to Livalo therapy, according to research in the Journal of Diabetes Investigation.
Brend Ray-Sea Hsu, MD, PhD, of the department of internal medicine at Chang Gung Memorial Hospital and Chang Gung University in Taoyuan, Taiwan, and colleagues analyzed data from 340 patients with type 2 diabetes treated with Livalo (pitavastatin, Kowa Pharmaceuticals) or atorvastatin for dyslipidemia between August 2013 and May 2014. Within the cohort, 96 patients were treated with pitavastatin (mean age, 61 years; 45.8% men; mean duration of diabetes, 5.1 years); 100 patients prescribed atorvastatin were switched to pitavastatin (mean age, 64 years; 49% men; mean duration of diabetes, 10.1 years); 144 patients continued with atorvastatin treatment (mean age, 65 years; 53.5% men; mean duration of diabetes, 10.5 years). Researchers measured lipid profiles and HbA1c changes in 222 patients who did not change their antidiabetes agent at baseline, 3 and 6 months.
Brend Ray-Sea Hsu
Among statin-naive patients treated with pitavastatin, researchers found a negative correlation between delta HbA1c and baseline HbA1c at 6 months after adjusting for age, BMI, pitavastatin dose and estimated glomerular filtration rate and HDL cholesterol (Spearman rank correlation = –0.358; P = .016); the negative association was stronger in patients who switched from atorvastatin to pitavastatin after adjustment (Spearman rank correlation = –0.478; P = .001)
Researchers classified participants in each of the three groups by baseline HbA1c into tertiles and found a significant improvement in HbA1c in the third tertile of baseline HbA1c in both the statin-naïve to pitavastatin group and the atorvastatin to pitavastatin group. In the poorest controlled tertile of patients in the pitavastatin group, HbA1c fell from 8.1% to 7.4% at 6 months (P = .018); HbA1c fell from 9.7% to 9% in the poorest controlled tertile of patients in the atorvastatin to pitavastatin group (P = .015).
“ A decrement of 0.7% in HbA1c just by changing from one statin to another statin of the same catego ry of potency is cost-effective,” Hsu told Endocrine Today. “ We should consider the effect of different statins on glycemic control and change the statin when it is i ndicated before we enforce anti diabetic agents in dyslipidemic patients with poorly controlled diabetes. Further large-scale trials are warranted to assess the long-term outcomes of different statin treatment in patients with diabetes and dyslipidemia.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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