May 26, 2006

Higher-dose Statin May Benefit Some Diabetics

NEW YORK (Reuters Health) - Treating diabetics who have signs of heart disease with a high dose of the cholesterol-lowering drug Lipitor (80 mg daily), rather than the normal dose of 10 mg daily, can lower the rate of major cardiovascular events by 25 percent, according to a new report.

In the main analysis of data from the study, increasing the dose of Lipitor (also called atorvastatin) was shown to provide significant clinical benefits for patients with heart disease.

In a subanalysis, Dr. James Shepherd of the University of Glasgow and colleagues set out to determine if this benefit applied to patients with heart disease and diabetes as well.

The study involved 1501 patients with baseline LDL levels (the "bad" cholesterol) of less than 130 mg/dL who were randomized to Lipitor at a dose of 10 or 80 mg per day and followed for a median of 4.9 years.

The final LDL levels reached in the 10- and 80-mg Lipitor groups were 98.6 and 77.0 mg/dL, respectively.

The primary cardiovascular event rate in the higher dose Lipitor group was 13.8 percent --significantly lower than the 17.9 percent rate noted in the lower dose group. In addition, the higher dose was also linked to a delay in the occurrence of cerebrovascular events like stroke.

Side effects were similar in both groups and no persistent elevations in liver enzymes were noted, the report indicates.

"Pending a definitive trial, these data suggest that the use of high-dose statin to achieve an LDL cholesterol level considerably lower than 100 mg/dL may be appropriate for patients with diabetes and coronary heart disease, irrespective of their initial LDL cholesterol level, age, duration of diabetes, or glycemic control," the authors conclude.

SOURCE: Diabetes Care June 2006.