Effect of pitavastatin on glucose, HbA1c and incident diabetes: A meta-analysis of randomized controlled clinical trials in individuals without diabetes

- First meta-analysis of the effect of pitavastatin on glucose metabolism or DM onset.
- 15 placebo/statin-controlled RCTs, 4815 non-diabetic patients (∼1600 person-years).
- No differences in FBG, HbA1c or DM onset with pitavastatin vs placebo/other statins.
- Analyses by type of control, dose or follow-up did not yield significant results.
- A non-significant trend favouring pitavastatin was observed over the long-term.

AimsWhether adverse effect of statins on glycaemic indices is common to all statins remains controversial and as yet data for pitavastatin are limited. We sought to assess the effects of pitavastatin on glycaemia and new-onset diabetes (NOD) in non-diabetic individuals using data from RCT pooled together by means of a meta-analysis.Materials and methodsWe searched Medline, Cochrane, Embase and clinical trials registries websites until November-2014 for ≥12-week follow-up placebo or statin-controlled RCT of pitavastatin that included participants without diabetes and reported on fasting blood glucose (FBG), HbA1c or NOD. We additionally sought studies by consulting with Kowa Ph. Ltd. The association of pitavastatin with the outcomes were estimated by random-effects meta-analyses. Heterogeneity was assessed by the I2 statistic and sensitivity and subgroup analyses, and publication bias with funnel plots and Egger and Harbord Tests.Results15 studies (approx. 1600 person-years) were included. No significant differences associated with pitavastatin (vs. control) were observed for FBG (MD −0.01 mg/dL [95%CI −0.77, 0.74], I2 = 0%), HbA1c (MD −0.03% [95%CI −0.11, 0.05], I2 = 43%) or NOD (RR 0.70 [95%CI 0.30, 1.61]; RD 0.0 [95%CI −0.004, 0.003]; I2 = 0%). Sensitivity and subgroup analyses (including type of control [placebo or other statin], pitavastatin dose or follow-up] did not yield significant results. Potential publication bias may occur for NOD.ConclusionsIn the present meta-analysis pitavastatin did not adversely affect glucose metabolism or diabetes development compared with placebo or other statins.