Glasgow, Scotland - New data from a large meta-analysis of major statin trials suggests the LDL-cholesterol-lowering drugs slightly increase the risk of developing diabetes mellitus [1]. Investigators stress, however, that clinical practice should remain unchanged in patients with moderate or high cardiovascular risk, given the low absolute risk of developing diabetes, particularly when when compared with the benefit of statins.
"We found that there was indeed a risk of diabetes, about 9%, but it isn't a worrying increase as had been suggested by other studies," said co-lead investigator Dr David Preiss (University of Glasgow, Scotland). "Then again, it wasn't a completely flat result. We did see something. Our message would be that people on statins should be those we think are at moderate to high cardiovascular risk in the future. If you look at that group of patients, then what we really want to see come out of the study is a reassuring message, because there is little question that the protective effects in reducing heart attacks, strokes, and so on heavily outweigh this risk of developing diabetes."
Dr Steven Nissen (Cleveland Clinic, OH), who was not involved in the meta-analysis, praised the researchers, calling their interpretation of the data "responsible." Most important, he agreed with their conclusions, stating that the benefits of statins exceed the risk of diabetes and that physicians should not alter clinical practice based on these findings.
"In all of these trials, the population with diabetes or the population with new-onset diabetes had the same benefit in terms of reduction in morbidity and mortality as did people who received statins who were not insulin resistant or who had prediabetes," Nissen told heartwire. "Whatever this effect is, it doesn't lessen the favorable effect of statins on clinical outcomes. I don't think people should hesitate to give prediabetic patients statins because they might develop diabetes a few weeks or a few months later and deny them all the other benefits of these drugs."
The results of the study, which was also led by Dr Naveed Sattar (University of Glasgow), are published online February 17, 2010 in the Lancet.
"We found that there was indeed a risk of diabetes, about 9%, but it isn't a worrying increase as had been suggested by other studies," said co-lead investigator Dr David Preiss (University of Glasgow, Scotland). "Then again, it wasn't a completely flat result. We did see something. Our message would be that people on statins should be those we think are at moderate to high cardiovascular risk in the future. If you look at that group of patients, then what we really want to see come out of the study is a reassuring message, because there is little question that the protective effects in reducing heart attacks, strokes, and so on heavily outweigh this risk of developing diabetes."
Dr Steven Nissen (Cleveland Clinic, OH), who was not involved in the meta-analysis, praised the researchers, calling their interpretation of the data "responsible." Most important, he agreed with their conclusions, stating that the benefits of statins exceed the risk of diabetes and that physicians should not alter clinical practice based on these findings.
"In all of these trials, the population with diabetes or the population with new-onset diabetes had the same benefit in terms of reduction in morbidity and mortality as did people who received statins who were not insulin resistant or who had prediabetes," Nissen told heartwire. "Whatever this effect is, it doesn't lessen the favorable effect of statins on clinical outcomes. I don't think people should hesitate to give prediabetic patients statins because they might develop diabetes a few weeks or a few months later and deny them all the other benefits of these drugs."
The results of the study, which was also led by Dr Naveed Sattar (University of Glasgow), are published online February 17, 2010 in the Lancet.
Para el artículo completo: The Heart.org
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