@article{c410307d2e85477db23f597a3956d197,
title = "Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin trials",
abstract = "Background: Trials of statin therapy have had conflicting findings on the risk of development of diabetes mellitus in patients given statins. We aimed to establish by a meta-analysis of published and unpublished data whether any relation exists between statin use and development of diabetes. Methods: We searched Medline, Embase, and the Cochrane Central Register of Controlled Trials from 1994 to 2009, for randomised controlled endpoint trials of statins. We included only trials with more than 1000 patients, with identical follow-up in both groups and duration of more than 1 year. We excluded trials of patients with organ transplants or who needed haemodialysis. We used the I2 statistic to measure heterogeneity between trials and calculated risk estimates for incident diabetes with random-effect meta-analysis. Findings: We identified 13 statin trials with 91 140 participants, of whom 4278 (2226 assigned statins and 2052 assigned control treatment) developed diabetes during a mean of 4 years. Statin therapy was associated with a 9% increased risk for incident diabetes (odds ratio [OR] 1·09; 95% CI 1·02-1·17), with little heterogeneity (I2=11%) between trials. Meta-regression showed that risk of development of diabetes with statins was highest in trials with older participants, but neither baseline body-mass index nor change in LDL-cholesterol concentrations accounted for residual variation in risk. Treatment of 255 (95% CI 150-852) patients with statins for 4 years resulted in one extra case of diabetes. Interpretation: Statin therapy is associated with a slightly increased risk of development of diabetes, but the risk is low both in absolute terms and when compared with the reduction in coronary events. Clinical practice in patients with moderate or high cardiovascular risk or existing cardiovascular disease should not change. Funding: None.",
author = "Naveed Sattar and David Preiss and Murray, {Heather M.} and Paul Welsh and Buckley, {Brendan M.} and {de Craen}, {Anton JM} and Seshasai, {Sreenivasa Rao Kondapally} and McMurray, {John J.} and Freeman, {Dilys J.} and Jukema, {J. Wouter} and Macfarlane, {Peter W.} and Packard, {Chris J.} and Stott, {David J.} and Westendorp, {Rudi G.} and James Shepherd and Davis, {Barry R.} and Pressel, {Sara L.} and Roberto Marchioli and Marfisi, {Rosa Maria} and Maggioni, {Aldo P.} and Luigi Tavazzi and Gianni Tognoni and John Kjekshus and Pedersen, {Terje R.} and Cook, {Thomas J.} and Gotto, {Antonio M.} and Clearfield, {Michael B.} and Downs, {John R.} and Haruo Nakamura and Yasuo Ohashi and Kyoichi Mizuno and Ray, {Kausik K.} and Ian Ford",
note = "Funding Information: Trials in this report were supported by research grants from the pharmaceutical industry. All authors apart from NS, DP, HMM, PW, SRKS, DJF, AJMdeC, and KKR were members of steering committees for some of these trials. NS has received consulting and lecture fees from Merck & Co, Pfizer, and AstraZeneca, and has received research grant support from Pfizer. JJMM has received payment from AstraZenca for advisory boards and lectures, JWJ has received research grants and minor speaker fees from Bristol-Myers Squibb, AstraZeneca, Pfizer, and Merck & Co. PWM has been involved in clinical trials of statins that were sponsored by BMS and AstraZeneca, and also received lecture fees from Bristol-Myers Squibb. CJP has received honoraria, research support, and has served on advisory boards for AstraZeneca, Merck & Co, Pfizer, Sanofi-Aventis, Servier, Roche, Bristol-Myers Squibb, and Diadexus Inc. DJS has received research funding from Bristol-Myers Squibb and funding for consultancy work from Pfizer and AstraZeneca. RGW has received support from Bristol-Myers Squibb as an investigator during the PROSPER trial. JS has worked as a consultant to AstraZeneca and a speaker for AstraZeneca and Pfizer. RM and RMM have received honoraria for lectures and institutional research grants from Bristol-Myers Squibb and AstraZeneca. APM has received research support and honoraria for lectures from AstraZeneca. LT has received honoraria for lectures and contributions for research from AstraZeneca, Pfizer, and Sanofi-Aventis. JK has served as chairman for the steering committees of the 4S and Corona trial, receiving honoraria for lectures and consultation from Merck & Co and AstraZeneca. TRP has received research grants from Pfizer and Merck & Co, and consulting and speaker honoraria from Pfizer, AstraZeneca, and Merck & Co-Schering Plough. TJC is a former employee and present contract employee of Merck & Co, and a shareholder in Merck & Co and Pfizer. AMG is a consultant for AstraZeneca, KOWZ Pharmaceuticals, Merck & Co, and Roche, is on advisory boards for DuPont and Novartis, and serves on corporate boards for Aegerion Pharmaceuticals, Arisaph Pharmaceuticals, and Vatera Capital. MBC has been a consultant and speaker for AstraZeneca, and a consultant for Merck & Co and GlaxoSmith Kline. YO has received consulting and lecture fees from Daiichi-Sankyo Company. KM has received honoraria from Daiichi Sankyo, Banyu Pharmaceuticals, Pfizer, Novartis, Astellas Pharma, Shonogi & Co, Kyowa Hakko Krini Co, Bayer Healthcare, and Mitsubishi Tanabe Pharma. KKR has received honoraria for attending advisory boards and for giving lectures, and has received unrestricted education and research grants from Pfizer, AstraZeneca, Merck & Co, Bristol-Myers Squibb, and Schering Plough. IF has previously received research funding and honoraria for presentations from Bristol-Myers Squibb in relation to the WOSCOPS trial, and research funding and honoraria for presentations from Bristol-Myers Squibb and the Sankyo Company for the Prosper trial. JRD is a USA government employee and the views expressed here are not those of the Veteran Affairs or Federal Government. RGW receives support from the Netherlands Genomics Initiative/Netherlands Organisation for Scientific Research ( NGI/NWO 911-03-016 ). GT was co-chairman (with LT) on the GISSI-HF trial, which was in part funded by an institutional grant from AstraZeneca. HN has received honoraria from Daiichi Sankyo, Merk Bangu, and Pzier, Japan. SRKS is supported by the Gates Cambridge Trust and the ORS Awards scheme at the University of Cambridge. DP, HMM, PW, BMB, AJMdeC, DJF, BRD, SLP, and JRD declare that they have no conflicts of interest. ",
year = "2010",
doi = "10.1016/S0140-6736(09)61965-6",
language = "English (US)",
volume = "375",
pages = "735--742",
journal = "The Lancet",
issn = "0140-6736",
publisher = "Elsevier Limited",
number = "9716",
}