| dc.description.abstract |
Recent reports indicate that statins are associated with an increased risk for new-onset
diabetes mellitus (DM) compared with placebo and that this relation is dose dependent. The
aim of this study was to perform a comprehensive network meta-analysis of randomized
controlled trials (RCTs) investigating the impact of different types and doses of statins on
new-onset DM. RCTs comparing different types and doses of statins with placebo were
searched for using the MEDLINE, Embase, and Cochrane databases. A search of RCTs
pertinent to this meta-analysis covering the period from November 1994 to October 2012
was conducted by 2 independent investigators using the MEDLINE, Cochrane, Google
Scholar, and Embase databases as well as abstracts and presentations from major cardiovascular
meetings. Seventeen RCTs reporting the incidence of new-onset DM during statin
treatment and including a total of 113,394 patients were identified. The RCTs compared
either a statin versus placebo or high-dose versus moderate-dose statin therapy. Among
different statins, pravastatin 40 mg/day was associated with the lowest risk for new-onset
DM compared with placebo (odds ratio 1.07, 95% credible interval 0.86 to 1.30).
Conversely, rosuvastatin 20 mg/day was numerically associated with 25% increased risk for
DM compared with placebo (odds ratio 1.25, 95% credible interval 0.82 to 1.90). The impact
on DM appeared to be intermediate with atorvastatin 80 mg/day compared with placebo
(odds ratio 1.15, 95% credible interval 0.90 to 1.50). These findings were replicated at
moderate doses. In conclusion, different types and doses of statins show different potential
to increase the incidence of DM. 2013 Elsevier Inc. All rights reserved. (Am J Cardiol
2013;111:1123e1130) |
