PMID: 22353198Feb 23, 2012Paper

Is the use of cholesterol-lowering drugs for the prevention of cardiovascular complications in type 2 diabetics evidence-based? A systematic review

Reviews on Recent Clinical Trials
Michel de LorgerilMikael Rabaeus

Abstract

Cholesterol-lowering drugs are often prescribed to patients with type 2 diabetes mellitus despite uncertainty about the benefits of this treatment in the prevention of cardiovascular complications. We here systematically review (PRISMA guidelines) the results of high-quality double blind trials testing whether cholesterol-lowering drugs (statins and fibrates) reduce mortality and cardiovascular complications specifically in type 2 diabetics. Trials with premature termination without pertinent medical justification or using nonrandomized subgroups of diabetics were excluded from the review. Only four trials met our predefined inclusion criteria. Among the 3 statin trials, CARDS was discontinued 2 years before the anticipated end and in the absence of significant effect on both overall and cardiovascular mortality, suggesting that the trial should not have been prematurely stopped. The two other statin trials showed no significant effect on the primary endpoint (relative risk 0.92, 95% CI 0.77 to 1.10 in 4D and 0.90, 95% CI 0.73 to 1.12 in ASPEN) and on both cardiovascular and overall mortality. Finally, the fibrate trial (FIELD) showed no significant benefit on the primary endpoint (relative risk 0.89, 95% CI 0.75 to 1.05) and m...Continue Reading

Citations

May 17, 2012·Expert Opinion on Drug Metabolism & Toxicology·André J Scheen
Aug 1, 2012·British Journal of Clinical Pharmacology·Nur Lisa ZaharanKathleen Bennett
Dec 20, 2018·Expert Review of Clinical Pharmacology·Uffe RavnskovRalf Sundberg
Jan 9, 2021·Expert Review of Clinical Pharmacology·Uffe RavnskovRalf Sundberg

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