scholarly journals Alirocumab vs usual lipid-lowering care as add-on to statin therapy in individuals with type 2 diabetes and mixed dyslipidaemia: The ODYSSEY DM-DYSLIPIDEMIA randomized trial

2018 ◽  
Vol 20 (6) ◽  
pp. 1479-1489 ◽  
Author(s):  
Kausik K. Ray ◽  
Lawrence A. Leiter ◽  
Dirk Müller-Wieland ◽  
Bertrand Cariou ◽  
Helen M. Colhoun ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trial ◽  
Statin Therapy ◽  
Lipid Lowering

scholarly journals Statin therapy and risk of polyneuropathy in type 2 diabetes: A Danish cohort study

2020 ◽  
Author(s):  
Frederik P. Kristensen ◽  
Diana H. Christensen ◽  
Brian C. Callaghan ◽  
Johnny Kahlert ◽  
Søren T. Knudsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Statin Therapy ◽  
Diabetic Polyneuropathy ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Study Cohort ◽  
Incident Type ◽  
Diabetes Patients

OBJECTIVE <p>Statins may reduce the risk of diabetic polyneuropathy (DPN) due to lipid-lowering and anti-inflammatory effects, but statins have also been associated with neurotoxicity. We examined whether statin therapy impacts the risk of DPN.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>We identified all Danish incident type 2 diabetes patients during 2002-2016. New users initiated statins between 180 days before and 180 days after their first diabetes record, while prevalent users had initiated statins before that period. Patients were followed for incident DPN using validated hospital diagnosis codes, starting 180 days after first diabetes record. Cox proportional hazard analysis was used to compute adjusted hazard ratios (aHRs) for DPN. </p> <p>RESULTS </p> <p>The study cohort comprised 59,255 (23%) new users, 75,528 (29%) prevalent users, and 124,842 (48%) non-users; median follow-up time was 6.2 years (interquartile range 3.4-9.6). The incidence rate of DPN events per 1000 person-years was similar in new users (4.0 [95% CI 3.8-4.2]), prevalent users (3.8 [3.6-3.9]) and non-users (3.8 [3.7-4.0]). The aHR for DPN was 1.05 (0.98-1.11) in new users, and 0.97 (0.91-1.04) in prevalent users, compared with statin non-users. New users had a slightly increased DPN risk during the first year (aHR 1.31 [1.12-1.53]) which vanished after more than 2 years of follow-up. Findings were similar in on-treatment and propensity score-matched analyses, and with additional adjustment for pre-treatment blood lipid levels.</p> <p>CONCLUSION </p> <p>Statin therapy is unlikely to increase or mitigate DPN risk in type 2 diabetes patients, although a small acute risk of harm cannot be excluded.</p>

scholarly journals Effects of evolocumab in individuals with type 2 diabetes with and without atherogenic dyslipidemia: An analysis from BANTING and BERSON

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Alberto J. Lorenzatti ◽  
Maria Laura Monsalvo ◽  
J. Antonio G. López ◽  
Huei Wang ◽  
Robert S. Rosenson
Keyword(s):  
Type 2 Diabetes ◽  
Statin Therapy ◽  
Apolipoprotein B ◽  
Lipid Lowering ◽  
Atherogenic Dyslipidemia ◽  
Lipid Lowering Therapy ◽  
Remnant Cholesterol ◽  
The Mean ◽  
Atherogenic Lipid

Abstract Background Atherogenic dyslipidemia (AD), characterized by increased concentrations of apolipoprotein B (ApoB)-containing particles, is often present in individuals with type 2 diabetes mellitus (T2DM). Non-high-density lipoprotein cholesterol (non-HDL-C), cholesterol transported by apolipoprotein B (ApoB)-containing particles), and total apoB are considered secondary goals of lipid-lowering therapy to guide treatment of residual cardiovascular risk. The BANTING and BERSON studies demonstrated that evolocumab added to statin therapy reduced atherogenic lipid and lipoproteins concentrations in patients with T2DM. Methods This post-hoc analysis combined data from two randomized, placebo-controlled trials, BANTING and BERSON, to investigate the effect of evolocumab (140 mg every two weeks [Q2W] or 420 mg monthly [QM]) on atherogenic lipid (LDL-C, non-HDL-C, VLDL-C, remnant cholesterol) and lipoproteins (ApoB, lipoprotein(a) (Lp[a])), and achievement of 2019 European Society of Cardiology/European Atherosclerosis Society lipid treatment goals in individuals with and without AD. Results In individuals with high TGs with (n = 389) and without (n = 196) AD receiving background statin therapy, evolocumab, compared with placebo, substantially reduced the cholesterol levels from all ApoB atherogenic lipoproteins (least squares (LS) mean LDL-C by 66.7% to 74.3%, non-HDL-C by 53.4% to 65.8%, median remnant cholesterol by 28.9% to 34.2%, VLDL-C by 16.1% to 19.6%) and median TGs levels (by 17.5% to 19.6%) at the mean of weeks 10 and 12. LS mean ApoB was significantly reduced by 41.5% to 56.6% at week 12. Results were consistent in diabetic individuals with normal TGs (n = 519). Evolocumab was also associated with a significant reduction in median Lp(a) by 35.0% to 53.9% at the mean of weeks 10 and 12. A majority (74.7% to 79.8%) of evolocumab-treated individuals achieved the goal of both an LDL-C < 1.4 mmol/L and an LDL-C reduction of at least 50%, > 75% achieved non-HDL-C < 2.2 mmol/L at the mean of weeks 10 and 12, and > 67% achieved ApoB < 65 mg/dL at week 12. Conclusions Evolocumab effectively reduced LDL-C, non-HDL-C, ApoB, Lp(a), and remnant cholesterol in individuals with T2DM with and without AD. Evolocumab Q2W or QM enabled most individuals at high/very-high cardiovascular disease risk to achieve their LDL-C, non-HDL-C, and ApoB recommended goals.

scholarly journals Statin therapy and risk of polyneuropathy in type 2 diabetes: A Danish cohort study

2020 ◽  
Author(s):  
Frederik P. Kristensen ◽  
Diana H. Christensen ◽  
Brian C. Callaghan ◽  
Johnny Kahlert ◽  
Søren T. Knudsen ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Statin Therapy ◽  
Diabetic Polyneuropathy ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Study Cohort ◽  
Incident Type ◽  
Diabetes Patients

OBJECTIVE <p>Statins may reduce the risk of diabetic polyneuropathy (DPN) due to lipid-lowering and anti-inflammatory effects, but statins have also been associated with neurotoxicity. We examined whether statin therapy impacts the risk of DPN.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>We identified all Danish incident type 2 diabetes patients during 2002-2016. New users initiated statins between 180 days before and 180 days after their first diabetes record, while prevalent users had initiated statins before that period. Patients were followed for incident DPN using validated hospital diagnosis codes, starting 180 days after first diabetes record. Cox proportional hazard analysis was used to compute adjusted hazard ratios (aHRs) for DPN. </p> <p>RESULTS </p> <p>The study cohort comprised 59,255 (23%) new users, 75,528 (29%) prevalent users, and 124,842 (48%) non-users; median follow-up time was 6.2 years (interquartile range 3.4-9.6). The incidence rate of DPN events per 1000 person-years was similar in new users (4.0 [95% CI 3.8-4.2]), prevalent users (3.8 [3.6-3.9]) and non-users (3.8 [3.7-4.0]). The aHR for DPN was 1.05 (0.98-1.11) in new users, and 0.97 (0.91-1.04) in prevalent users, compared with statin non-users. New users had a slightly increased DPN risk during the first year (aHR 1.31 [1.12-1.53]) which vanished after more than 2 years of follow-up. Findings were similar in on-treatment and propensity score-matched analyses, and with additional adjustment for pre-treatment blood lipid levels.</p> <p>CONCLUSION </p> <p>Statin therapy is unlikely to increase or mitigate DPN risk in type 2 diabetes patients, although a small acute risk of harm cannot be excluded.</p>

scholarly journals Comparison of Lipid-Lowering Effects of Anagliptin and Miglitol in Patients With Type 2 Diabetes: A Randomized Trial

2020 ◽  
Vol 12 (2) ◽  
pp. 73-78
Author(s):  
Takahiro Iijima ◽  
Kazutaka Aoki ◽  
Yoshinobu Kondo ◽  
Yasuo Terauchi
Keyword(s):  
Type 2 Diabetes ◽  
Randomized Trial ◽  
Lipid Lowering

scholarly journals Intensive Lipid Lowering by Statin Therapy Does Not Improve Vasoreactivity in Patients With Type 2 Diabetes

2002 ◽  
Vol 22 (5) ◽  
pp. 799-804 ◽  
Author(s):  
Ronald W. van Etten ◽  
Eelco J.P. de Koning ◽  
Marina L. Honing ◽  
Erik S. Stroes ◽  
Carlo A. Gaillard ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Statin Therapy ◽  
Lipid Lowering

scholarly journals Pharmacogenetics of statin therapy and the endothelial function parameters in patients with type 2 diabetes mellitus

2016 ◽  
Vol 19 (3) ◽  
pp. 204-211
Author(s):  
Nadezhda O. Lebedeva ◽  
Olga K. Vikulova ◽  
Alexei G. Nikitin ◽  
Minara Sh. Shamkhalova ◽  
Marina V. Shestakova ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Endothelial Function ◽  
Statin Therapy ◽  
Lipid Lowering ◽  
Before And After ◽  
Atorvastatin Therapy

Aim. To investigate the association of variation in lipid-lowering response and endothelial function (EF) parameters after atorvastatin therapy in patients with type 2 diabetes mellitus (T2DM) with genetic markers of atherosclerosis.Methods. We included 97 patients with T2DM who were prescribed atorvastatin. Fasting lipid profiles and EF parameters were assessed before and after 12 months of statin therapy. For EF evaluation, we performed pulse-wave analysis during reactive hyperaemia. The genotypes for polymorphic markers were identified by real-time polymerase chain reaction with TaqMan probes. The statistical analysis included Wilcoxon, Mann–Whitney and Kruskal–Wallis tests. P-values 0.05 were considered statistically significant.Results. With statin therapy, PPARG2Pro/Pro patients had significantly lower TC and LDL-C levels than PPARG2 Pro/Ala and PPARG2 Ala/Ala patients (TC: 20.74% vs. 4.6% and 5.61%; p = 0.04 and LDL-C: 26.00% vs. 6.11% and 7.32%; p = 0.029). Patients with АРОЕЕ4/Е4 had significantly lower TC and TG levels than other АРОЕ patients (TC: -46.25% for Е4/Е4 vs. +33.33% for Е4/Е2, +5.73% for Е3/Е2, +11.80% for Е3/Е4, -10.92% for Е3/Е3, р = 0,01; TG: -56.52% for Е4/Е4 vs. +24.43% for Е4/Е2, +19.63% for Е3/Е2, +8.05% for Е3/Е4, -20.00% for Е3/Е3, р = 0.04). The patients with GG for TNFα G(238)A and GA for TNFα G(308)A had significantly greater amplitude of post-occlusive wave increase (Apw) than patients with GA for TNFα G(238)A and GG for TNFα G(308)A (+8.16 % vs. -0.93%, р = 0,04; +44% vs. -4.4%, p = 0.004, respectively).Conclusion. PPARG2Pro12Ala and АРОЕE2/Е3/Е4 polymorphism contributed to the between-patient variability in the response to statin therapy in patients with T2DM. Significant associations of the TNFαgene polymorphism with EF in patients with T2DM suggest an important role of inflammation in the pathogenesis of MVD.

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