New Study Fine-Tunes Diabetes, Statin Link
By SHIRLEY S. WANG
A new analysis suggests that patients with risk factors for diabetes are significantly more likely than others to develop the disease when taking popular cholesterol-lowering drugs. But the benefits of these drugs, called statins, in preventing heart disease still outweigh the risk, according to the study published Thursday in the medical journal Lancet.
Statin use for heart disease prevention has come under scrutiny because of a growing body of data suggesting that the medicines, such as Lipitor and Crestor, also increase patients' susceptibility to diabetes.
In February, the Food and Drug Administration announced that statin makers would be required to add language about diabetes risk to their labels.
Cholesterol regulators were the third-biggest class of drug in 2011, ringing up $38.7 billion in worldwide sales, according to IMS Health, which tracks prescription drug sales.
.Thursday's study involved number-crunching of existing data from a 17,000-patient trial known as Jupiter. It suggests that those with diabetes risk factors, such as obesity and higher blood-sugar levels while fasting, are the ones who appear at increased risk of developing the full-blown disease while taking a statin.
On the other hand, those without existing risk factors don't show an elevated risk of getting diabetes over the five-year period, the report said.
The study was funded by Astra-Zeneca PLC, the maker of Crestor.
Among patients at high risk of diabetes, 134 heart attacks, strokes or deaths were estimated to have been prevented in the study, while 54 new cases of diabetes were diagnosed. In the low-risk group, 86 heart attacks, strokes or deaths were prevented, with no new cases of diabetes.
"For this [latter] group, there's cardiovascular benefit and no diabetes risk," said Paul Ridker, a cardiologist and professor of medicine at Harvard Medical School, who was the first author on the study. He added, "The cardiovascular benefits simply outweigh the diabetes risk, even among those with the highest risk for diabetes.
Previously, it wasn't known which types of patients developed diabetes on statins, and this study provides a "positive contribution" by identifying a pool of patients who appear at greater risk, said Eric Topol, a cardiologist and chief academic officer of the Scripps Research Institute in La Jolla, Calif., who wasn't involved in the study.
However, Dr. Topol said he remained concerned about the diabetes risk for all patients receiving a statin for preventive purposes.
"Although there is a narrow trade-off with the benefits of reducing heart disease, this paper doesn't mitigate the [diabetes] concern to me," said Dr. Topol. Statin use is appropriate in some patients, but many patients don't know about the risks and need to be better informed, he said.
Dr. Ridker concured. "Our hope in these data is to better inform discussions between physicians and patients who are considering using statins," he said.
Write to Shirley S. Wang at [email protected]
A version of this article appeared August 10, 2012, on page A3 in the U.S. edition of The Wall Street Journal, with the headline: New Study Fine-Tunes Diabetes, Statin Link
BUSINESSAugust 9, 2012, 7:38 p.m. ET