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Intensive-Dose Statin Therapy Associated With Increased Risk of Diabetes

An analysis of data from previously published studies indicates that intensive-dose statin therapy is associated with an increased risk of new-onset diabetes compared with moderate-dose therapy, according to a study in The Journal of the American Medical Association.

Compared with placebo, statin therapy significantly reduces cardiovascular events among individuals with and without a history of diabetes mellitus. Recently, findings from several trials comparing intensive- to moderate-dose statin therapy suggested an excess risk of new diabetes among those treated with intensive statin regimens, according to background information in the article.

"Given the cardiovascular benefits of statins and the likely increasing use of intensive statin regimens, it’s important to quantify any potential long-term risks to enable physicians and patients to make informed choices," the authors wrote.

David Preiss, MRCP, of the University of Glasgow in the United Kingdom, and colleagues examined the association of intensive-dose statin therapy vs. moderate-dose therapy with the development of diabetes and the occurrence of major cardiovascular events. They conducted a meta-analysis of published and unpublished data from relevant clinical trials and identified five statin trials that met criteria for inclusion in the analysis.

The five randomized clinical trials provided data on 32,752 nondiabetic participants over a weighted average follow-up of 4.9 years. During follow-up, 2,749 subjects (8.4%) developed diabetes (1,449 of whom were assigned to intensive-dose therapy, and 1,300 to moderate-dose therapy), and 6,684 (20.4%) experienced a major cardiovascular event (3,134 assigned to intensive-dose therapy and 3,550 to moderate-dose therapy). There were 149 more cases of incident diabetes in participants assigned to intensive statin treatment than in those receiving moderate therapy and 416 fewer patients with cardiovascular events who received intensive-dose therapy.

An analysis of the data indicated that the use of intensive-dose statin therapy compared with moderate-dose statin therapy was associated with a higher incidence of new-onset diabetes. However, intensive statin therapy was associated with fewer major cardiovascular events.

"Our findings suggest that clinicians should be vigilant for the development of diabetes in patients receiving intensive statin therapy," the authors wrote. "In conclusion, this meta-analysis extends earlier findings of an increased incidence of diabetes with statin therapy by providing evidence of a dose-dependent association."

— Source: American Medical Association