Fiche publication
Date publication
juin 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr VERGES Bruno
Tous les auteurs :
Sattar NA, Ginsberg H, Ray K, Chapman MJ, Arca M, Averna M, Betteridge DJ, Bhatnagar D, Bilianou E, Carmena R, Ceska R, Corsini A, Erbel R, Flynn PD, Garcia-Moll X, Gumprecht J, Ishibashi S, Jambart S, Kastelein JJ, Maher V, da Silva PM, Masana L, Odawara M, Pedersen TR, Rotella CM, Salti I, Teramoto T, Tokgozoglu L, Toth PP, Valensi P, Verges B
Lien Pubmed
Résumé
Reducing low-density lipoprotein cholesterol (LDL-C) levels using statins is associated with significant reductions in cardiovascular (CV) events in a wide range of patient populations. Although statins are generally considered to be safe, recent studies suggest they are associated with an increased risk of developing Type 2 diabetes (T2D). This led the US Food and Drug Administration (FDA) to change their labelling requirements for statins to include a warning about the possibility of increased blood sugar and HbA1c levels and the European Medicines Agency (EMA) to issue guidance on a small increased risk of T2D with the statin class. This review examines the evidence leading to these claims and provides practical guidance for primary care physicians on the use of statins in people with or at risk of developing T2D. Overall, evidence suggests that the benefits of statins for the reduction of CV risk far outweigh the risk of developing T2D, especially in individuals with higher CV risk. To reduce the risk of developing T2D, physicians should assess all patients for T2D risk prior to starting statin therapy, educate patients about their risks, and encourage risk-reduction through lifestyle changes. Whether some statins are more diabetogenic than others requires further study. Statin-treated patients at high risk of developing T2D should regularly be monitored for changes in blood glucose or HbA1c levels, and the risk of conversion from pre-diabetes to T2D should be reduced by intensifying lifestyle changes. Should a patient develop T2D during statin treatment, physicians should continue with statin therapy and manage T2D in accordance with relevant national guidelines.
Référence
Atheroscler Suppl. 2014 Jun;15(1):1-15
