Efficacy and Safety of Switching from Low-Dose Statin to High-Intensity Statin for Primary Prevention in Type 2 Diabetes: A Randomized Controlled Trial

被引:5
|
作者
Thongtang, Nuntakorn [1 ]
Piyapromdee, Jirasak [1 ]
Tangkittikasem, Natthakan [1 ]
Samaithongcharoen, Kittichai [1 ]
Srikanchanawat, Nithiwat [1 ]
Sriussadaporn, Sutin [1 ]
机构
[1] Mahidol Univ, Siriraj Hosp, Fac Med, Div Endocrinol & Metab,Dept Med, 2 Wanglang Rd, Bangkok 10700, Thailand
来源
DIABETES METABOLIC SYNDROME AND OBESITY-TARGETS AND THERAPY | 2020年 / 13卷
关键词
efficacy; safety; high-intensity statin; primary prevention; Thai patients; type; 2; diabetes; CARDIOVASCULAR-DISEASE; ATORVASTATIN; THERAPY; CHOLESTEROL; PHARMACOGENETICS; ROSUVASTATIN; METAANALYSIS; PRAVASTATIN; GUIDELINES; MANAGEMENT;
D O I
10.2147/DMSO.S219496
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Introduction: Statin intensification is required in patients who have high-risk for cardiovascular events. However, it is unclear if this is needed in whom plasma LDL-C target was achieved with low-dose statin for primary prevention. We investigated the efficacy and safety of switching from low-dose statin to high-intensity statin among type 2 diabetes (T2D) who had achieved plasma LDL-C <100 mg/dl with low-dose statin treatment. Methods: T2D patients with no atherosclerotic cardiovascular disease who had plasma LDL-C level <100mg/dl while taking simvastatin <= 20 mg/day were randomized to continue using the same dosage of simvastatin (low-dose statin group; LS) for 12 weeks, or to switch to atorvastatin 40 mg/day for 6 weeks, and then, if tolerated, to atorvastatin 80 mg/day for 6 weeks (high-intensity statin group; HS). Biochemical test and adverse eventswere evaluated at baseline, 6 weeks, and 12 weeks. Results: One hundred and fifty patients (76 LS, 74 HS, mean age 58.9 +/- 8.9 years, 72% female) were included. The mean baseline plasma LDL-C level on statin was slightly higher in the HS group (71.9 +/- 13.6 vs. 68.1 +/- 14.2 mg/dl, p=0.09). The HS group had a significantly lower plasma LDL-C level at both 6 and 12 weeks (both p<0.001). Plasma LDL-C <40 mg/dl was foundmore frequently in the HS group (23.0% vs. 3.9%, p<0.001). Discontinuation of statin due to adverse effects was more frequent in the HS group (5.4% vs. 1.3%, p=0.38 for atorvastatin 40 mg/day, 12.2% vs. 1.3%, p=0.03 for atorvastatin 80 mg/day). No serious adverse events were observed in either group. Conclusion: Switching from low-dose statins to high-intensity statins resulted in a significant reduction in plasma LDL-C levels, and was fairly well tolerated during a 12week study period.
引用
收藏
页码:423 / 431
页数:9
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