Higher potency statins and the risk of new diabetes: multicentre, observational study of administrative databases

In the first two years of regular statin use, we observed a significant increase in the risk of new onset diabetes with higher potency statins compared with lower potency agents (rate ratio 1.15, 95%

C. R. Dormuth; K. B. Filion; J. M. Paterson; M. T. James; G. F. Teare; C. B. Raymond; E. Rahme; H. Tamim; L. Lipscombe; for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators

2014

Scholarcy highlights

  • Labels on statin medications in the United States include information concerning glycaemic effects, including diabetes and increases in haemoglobin A1c or fasting plasma glucose
  • In the first two years of regular statin use, we observed a significant increase in the risk of new onset diabetes with higher potency statins compared with lower potency agents
  • Higher potency statin use is associated with a moderate increase in the risk of new onset diabetes compared with lower potency statins in patients treated for secondary prevention of cardiovascular disease
  • In this study of over 136 936 patients hospitalised for a major cardiovascular event or procedure, a group in which statin treatment is strongly indicated for secondary prevention, we observed a moderately increased risk of new onset diabetes in patients prescribed higher potency statins compared with lower potency statins
  • We found modest evidence that there is a harmful association between statin potency and new diabetes in patients treated for secondary prevention of cardiovascular disease
  • Clinicians should consider our study results when choosing between lower potency and higher potency statins in secondary prevention patients, perhaps bearing in mind that head to head randomised trials of higher potency versus lower potency statins have not shown a reduction in all cause mortality or serious adverse events in secondary prevention patients with stable disease
  • We acknowledge the assistance of Dr James Wright, who provided his expert understanding of randomised trials of statins

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