People with type 2 diabetes who have progressed to kidney failure don’t gain much benefit from treatment with a statin drug like Lipitor. Lipitor did not appear to lower the risk of heart attack or stroke much in such patients, according to results of a large study presented last week in St. Louis at the meeting of the American Society of Nephrology.
In the trial, investigators treated a total of 1255 type 2 diabetic patients who were on hemodialysis with Lipitor or a matching placebo pill for an average of four years.
The good news of the trial," said. Dr. Christoph Wanner from University Clinic in Wuerzburg was that, Lipitor was very safe and it did lower LDL ("bad") cholesterol an average of 41 percent,
"The conservative news," he said, is that the reduction in the combination of cardiac death, non-fatal heart attack and stroke with Lipitor was slight compared with the rate in the placebo group. "There was an 8 percent risk reduction with statin therapy, which is not statistically significant."
This was a bit of a surprise, Wanner noted, given recent findings that Lipitor has significant benefits for people with type 2 diabetes who have not developed major kidney disease.
The take-home message from the current trial "is to provide statin treatment to patients with type 2 diabetes during the early stage of disease progression and not when it’s too late," Wanner said.
"Type 2 diabetics who have reached terminal renal failure and are maintained on chronic hemodialysis have the highest risk of cardiovascular death among any patient group," Wanner pointed out. "So probably it’s too late in the vascular life of the patient to (start) statin treatment."