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与阿托伐他汀和瑞舒伐他汀相比,匹伐他汀引发新发糖尿病的风险:一项系统评价与荟萃分析。

Risk of new onset diabetes mellitus with pitavastatin as compared to atorvastatin and rosuvastatin: a systematic review and meta-analysis.

作者信息

Singh Harmanjit, Kaur Sangambir, Kaushal Parul, Sharma Jatin, Singla Mandeep

机构信息

Department of Pharmacology, Government Medical College & Hospital, Chandigarh, India.

Department of Community Medicine, Government Medical College & Hospital, Chandigarh, India.

出版信息

Expert Rev Clin Pharmacol. 2024 Dec;17(12):1173-1181. doi: 10.1080/17512433.2024.2433603. Epub 2024 Nov 25.

Abstract

BACKGROUND

Statins are linked to the risk of new-onset diabetes mellitus (NODM). While atorvastatin and rosuvastatin are often associated with NODM, pitavastatin may carry a lower risk. This systematic review and meta-analysis (SRMA) evaluated the impact of pitavastatin on NODM compared to atorvastatin and rosuvastatin.

METHODS

We conducted a systematic literature search using PubMed, CENTRAL, EMBASE, and ClinicalTrials.gov. Two authors independently screened studies, assessed the risk of bias using Joanna Briggs Institute, Newcastle-Ottawa, and Scottish Intercollegiate Guidelines Network checklists, and extracted data. The analysis was performed using RevMan 5.4.1, and results were represented as risk ratios (RR) with 95% confidence intervals (CI) and heterogeneity was evaluated using the I statistic.

RESULTS

Of 517 records screened, 13 studies were included, comprising observational studies, and randomized controlled trials. Most of the studies showed pitavastatin to be associated with a lower or no risk of NODM. Meta-analysis revealed that pitavastatin had a lower risk of NODM compared to atorvastatin (RR = 0.86, 95% CI = 0.79-0.93,  = 0.0002) and rosuvastatin (RR = 0.77, 95% CI = 0.71-0.84,  < 0.00001).

CONCLUSION

Pitavastatin poses a lower risk of NODM than other statins, making it a potentially safer option for patients requiring long-term statin therapy.

PROTOCOL REGISTRATION

www.crd.york.ac.uk/prospero identifier is CRD42022371741.

摘要

背景

他汀类药物与新发糖尿病(NODM)风险相关。阿托伐他汀和瑞舒伐他汀常与NODM有关,而匹伐他汀的风险可能较低。本系统评价和荟萃分析(SRMA)评估了匹伐他汀与阿托伐他汀和瑞舒伐他汀相比对NODM的影响。

方法

我们使用PubMed、CENTRAL、EMBASE和ClinicalTrials.gov进行了系统的文献检索。两名作者独立筛选研究,使用乔安娜·布里格斯研究所、纽卡斯尔-渥太华和苏格兰跨学院指南网络清单评估偏倚风险,并提取数据。使用RevMan 5.4.1进行分析,结果以风险比(RR)和95%置信区间(CI)表示,并使用I统计量评估异质性。

结果

在筛选的517条记录中,纳入了13项研究,包括观察性研究和随机对照试验。大多数研究表明,匹伐他汀与较低或无NODM风险相关。荟萃分析显示,与阿托伐他汀相比,匹伐他汀发生NODM的风险较低(RR = 0.86,95%CI = 0.79 - 0.93,P = 0.0002),与瑞舒伐他汀相比也是如此(RR = 0.77,95%CI = 0.71 - 0.84,P < 0.00001)。

结论

与其他他汀类药物相比,匹伐他汀引发NODM的风险较低,这使其成为需要长期他汀类药物治疗的患者的一个潜在更安全的选择。

方案注册

www.crd.york.ac.uk/prospero标识符为CRD42022371741。

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