Efficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170 255 patients from 76 randomized trials

Mills, Edward J.; Wu, Ping; Chong, Gina; Ghement, Isabella; Singh, Sonal; Akl, Elie A.; Eyawo, Oghenowede; Guyatt, Gordon; Berwanger, Otávio; Briel, Matthias

doi:10.1093/qjmed/hcq165

Cited by 279 publications

(190 citation statements)

References 109 publications

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“…The current findings confirm and extend the results of the JUPITER trial, which was the first to find that new-onset diabetes was 27% more common in patients treated with statins than in those receiving placebo (5) Meta-analyses of clinical trials, however, showed a weaker increased risk of newonset diabetes by ;10% (7,8,23). Finally, the SPARCL (Stroke Prevention by Aggressive Reduction in Cholesterol Levels) trial showed that high-dose atorvastatin treatment compared with placebo is associated with a 37% excess risk of diabetes (24).…”

Section: Comparison With Available Evidencesupporting

confidence: 81%

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Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

et al. 2014

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OBJECTIVETo investigate the relationship between adherence with statin therapy and the risk of developing diabetes. RESEARCH DESIGN AND METHODSThe cohort comprised 115,709 residents of the Italian Lombardy region who were newly treated with statins during 2003 and 2004. Patients were followed from the index prescription until 2010. During this period, patients who began therapy with an antidiabetic agent or were hospitalized for a main diagnosis of type 2 diabetes were identified (outcome). Adherence was measured by the proportion of days covered (PDC) with statins (exposure). A proportional hazards model was fitted to estimate hazard ratios (HRs) and 95% CIs for the exposure-outcome association, after adjusting for several covariates. A set of sensitivity analyses was performed to account for sources of systematic uncertainty. RESULTSDuring follow-up, 11,154 cohort members experienced the outcome. Compared with patients with very-low adherence (PDC <25%), those with low (26-50%), intermediate (51-75%), and high ( ‡75%) adherence to statin therapy had HRs (95% CIs)

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Section: Comparison With Available Evidencesupporting

confidence: 81%

“…patients treated with statins, the risk of developing diabetes was higher than in those treated with placebo (7,8). It should be noted, however, that none of these trials were designed to look for diabetes and that the meta-analyses used a range of methods to detect the condition.…”

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confidence: 99%

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

et al. 2014

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“…15,[23][24][25][26][27][28] The first 3 statins approved in the United States (lovastatin in 1987, simvastatin in 1991, and pravastatin in 1991) are fungus-derived (Tables 3-5) (Table 6). …”

Section: Overview Of the Statinsmentioning

confidence: 99%

Pediatric Statin Administration: Navigating a Frontier with Limited Data

Wagner

Abdel‐Rahman

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Increasingly, children and adolescents with dyslipidemia qualify for pharmacologic intervention. As they are for adults, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) are the mainstay of pediatric dyslipidemia treatment when lifestyle modifications have failed. Despite the overall success of these drugs, the magnitude of variability in dose-exposure-response profiles contributes to adverse events and treatment failure. In children, the cause of treatment failures remains unclear. This review describes the updated guidelines for screening and management of pediatric dyslipidemia and statin disposition pathway to assist the provider in recognizing scenarios where alterations in dosage may be warranted to meet patients' specific needs.

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“…Even in RCTs, the risk of NODM was reduced by 30% with pravastatin [9], was neutral with simvastatin [10], but was nonsignificantly increased by 15% with atorvastatin [11]. Against these backgrounds, several metaanalyses [12][13][14][15][16][17][18][19] have been conducted and have yielded possible evidence of a statin-DM association. However, such evidence -the increased likelihood of NODM in statin users than nonusers or in intensive rather than moderate dose users-does not indicate whether NODM is really harmful and consequently cancels any cardioprotective benefit of statin.…”

Section: Introductionmentioning

confidence: 99%

Statins Cardiovascular Benefits Outweigh their Diabetogenicity: A Direct Comparison between Number Needed to Treat and Number Needed to Harm

Shimoyama¹

2015

Adv Pharmacoepidemiol Drug Saf

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Efficacy and safety of statin treatment for cardiovascular disease: a network meta-analysis of 170 255 patients from 76 randomized trials

Abstract: Statin therapies offer clear benefits across broad populations. As generic formulations become more available efforts to expand access should be a priority.

Cited by 279 publications

References 109 publications

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study

Pediatric Statin Administration: Navigating a Frontier with Limited Data

Statins Cardiovascular Benefits Outweigh their Diabetogenicity: A Direct Comparison between Number Needed to Treat and Number Needed to Harm

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