High-intensity statin use low in patients with diabetes, high CVD risk
NASHVILLE, Tenn. - Patients with type 2 diabetes at very high risk for cardiovascular disease are often not taking high-intensity statins, further increasing their risk, and frequently modify their initial statin therapy, indicating intolerability or ineffectiveness of the drug, according to study findings presented here.
In a retrospective cohort study, researchers found that less than 23% of patients with type 2 diabetes at high risk for CVD initiated treatment with a high-intensity statin, whereas approximately 80% of patients who initiated statin therapy modified their index treatment.
Ruben G. Quek, PhD , of Amgen Global Health Economics, and colleagues at other institutions analyzed data from 71,872 adults diagnosed with type 2 diabetes who initiated a lipid-lowering treatment with a statin and/or Zetia (ezetimibe, Merck) between January 2007 and June 2011. Patients with type 2 diabetes were classified into two very high risk cohorts. The first group (n = 9,823) had prior CVD, whereas the second group (n = 62,049) had no prior CVD but had two risk factors - age (older than 45 years for men, older than 55 years for women) and hypertension.
Researchers analyzed the patients’ initiation of statin therapy according to intensity across the study years, first treatment modification (either a switch in medication, reinitiation after temporary discontinuation of 60 or more days, or permanent discontinuation) and the time to first treatment modification. Patients in each cohort were stratified by age groups (younger than and older than 65 years).
Among patients younger than 65 years, 90% were prescribed statin monotherapy, 66% to 78% were prescribed a moderate-intensity statin and 7% to 22% were prescribed a high-intensity statin on the index date.
In cohorts 1 and 2, 21% and 25% reinitiated the same statin treatment, 18% and 13% switched to a new statin, 12% and 12% permanently discontinued all treatment, and 3% and 2% switched to a nonstatin lipid-lowering treatment, respectively, as their first treatment modification. In addition, 44% to 52% of patients with one treatment modification has a second modification, and researchers saw a similar trend in patients older than 65 years.
“Among [patients with type 2 diabetes] at very high CVD risk, index statin treatment modifications that potentially imply statin intolerability and/or ineffectiveness are frequent,” the researchers wrote. “High-intensity statin therapy initiation is low potentially resulting in an increased risk of CVD.” - by Regina Schaffer
Quek R, et al. Abstract #413. Presented at: AACE 24th Annual Scientific & Clinical Congress; May 13-17, 2015; Nashville, Tenn.
Disclosure: The study was sponsored by Amgen, and Quek is an employee and shareholder of Amgen.