Benefit / Risk Assessment Of Statins Like Lipitor May Depend On Whether It Is A Medically Necessary Drug Therapy For The Particular Patient
(Posted by Tom Lamb at DrugInjuryWatch.com)
There is an ongoing debate in the medical community about whether cholesterol drugs like the very popular Lipitor from Pfizer is over-prescribed in part due to aggressive marketing by the drug company.
Certainly, there is a population of patients for which a statin drug like Lipitor is medically necessary to maintaining their health.
On the other hand, however, some people would probably be better off addressing their cholesterol problem with a healthier diet and more exercise rather than by just taking a pill as the "fix" for the rest of their life. This is especially true when regularly taking a statin drug such as Lipitor forever going forward can cause the person to develop type 2 diabetes or diabetes mellitus.
In fact a recent medical journal article reported on a medical study that had as its objective to investigate the relationship between the regular use of statins such as Lipitor and the risk of developing diabetes.
From this article, "Statins and the Risk of Diabetes: Evidence From a Large Population-Based Cohort Study", published online June 26, 2014 in the Diabetes Care medical journal:
METHODS The 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)....
CONCLUSIONS In a real-world setting, the risk of new-onset diabetes rises as adherence with statin therapy increases. Benefits of statins in reducing cardiovascular events clearly overwhelm the diabetes risk.
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For some commentary on this recent medical journal article about the association between cholesterol drugs like Lipitor and new onset type 2 diabetes we turn to this July 17, 2014 Medscape Medical News report, "New Study Finds Diabetes Risk Rises With Statin Adherence":
Naveed Sattar, MD, PhD, professor of metabolic medicine at the University of Glasgow, Scotland, told Medscape Medical News that this study further supports the conclusion of a recent clinical trial review from the diabetes subpanel of the US National Lipid Association Expert Panel on Statin Safety, for which he was senior author.
Commenting on the new study, Dr. Sattar said: "It's observational, and with this, one always has the issue of potential confounding, which is hard to ever fully overcome with such designs. That noted, this...does seem to suggest an...association using compliance...so it fits with the trial data."
He also agreed with the author's benefit/risk conclusion. "The vascular benefits of statins remain important, and one must remember that good compliance will also lead to lower cardiovascular disease [CVD] risk....Some will suggest that the diabetes risk in some will match the CVD benefits, especially on a high-dose statin, but one must remember that preventing 1 hard CVD event is not 'outweighed or equaled' by 1 extra diabetes case, so the arguments have to be carefully considered," he told Medscape Medical News.
And -- as suggested at the outset of this article as regards the increased risk of developing diabetes compared to the relative benefit of using Lipitor or some other statin -- we get this take-away point from that same report:
Dr. Sattar told Medscape Medical News, "Essentially, the statin-diabetes effect is real. The key message for clinicians is to reiterate strongly that patients can offset diabetes risk once on a statin by taking lifestyle changes seriously."
For some background information on this drug safety issue, see our January 2014 article "Pfizer's Lipitor Statin Drug For Treatment Of High Cholesterol Linked To An Increased Risk Of Type-2 Diabetes In Some Older And Post-Menopausal Women".
We will continue to monitor the medical journals for new articles concerning diabetes mellitus or type 2 diabetes and Lipitor as well as other statin medications.
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