‘Pitavastatin’ safety proven ‘Statin’, an existing treatment, impairs the body’s ability to maintain blood sugar and increases the risk of developing new diabetes ‘Pitavastatin’ lowers fasting blood sugar and improves HDL cholesterol levels
If dyslipidemia is diagnosed, regular exercise and improvement in eating habits and drug treatment should be performed. In the case of dyslipidemia, statin drugs are prescribed to lower LDL cholesterol levels and prevent cardiovascular diseases. Getty Images Korea
Dyslipidemia, diabetes, and hypertension are the most common causes of cardiovascular disease in modern people. Among these, dyslipidemia refers to a condition in which there is an abnormality in lipid metabolism in the blood.
Among the general public, it is better known as ‘hyperlipidemia’, which is an increase in lipid levels such as LDL (low-density lipoprotein) cholesterol, triglyceride (TG), and total cholesterol (TC), but it refers to both hyperlipidemia and an unbalanced blood lipid level.
In particular, since these diseases affect each other and symptoms often appear together, it is necessary to manage not only the figures for the diagnosed disease but also all other figures. In fact, according to the ‘2022 Dyslipidemia Fact Sheet’ of the Korean Association for Lipid and Arteriosclerosis, 87.1% of diabetic patients and 72.1% of hypertensive patients were found to have dyslipidemia as of 2020.
If you are diagnosed with dyslipidemia, diabetes, or hypertension, you need to take medication along with regular exercise and improvement in eating habits.
Statins are most commonly used to treat dyslipidemia, but they can increase the risk of new diabetes as a side effect. In response, the U.S. Food and Drug Administration (FDA) has mandated that most statin drugs include a warning that ‘can increase HbA1c levels’ since 2012.
The reason why the risk of developing diabetes increases when taking statins is because statins impair the body’s ability to maintain blood sugar at an appropriate level. On the other hand, antidiabetic drugs improve blood sugar homeostasis in the body.
Due to these characteristics, conflicting pharmacological effects may occur in the body when statin drugs and diabetes drugs are taken together.
The research team led by Professor Bahar Arikan Tarim of Internal Medicine at Kartal Research and Education Hospital in Turkiye had 131 patients taking type 2 diabetes medications take pitavastatin, atorvastatin, and rosuvastatin for six months.
As a result of the study, the fasting blood sugar (FPG) of the atorvastatin and rosuvastatin groups decreased by 3.5 mg/dL and 6.5 mg/dL, respectively, showing no significant difference, while the pitavastatin group showed a significant difference by 19.0 mg/dL.
In addition, the drop in glycated hemoglobin (HbA1c) level in the pitavastatin group was 0.75%, which was significantly lower than the 0.10% decrease in atorvastatin and the 0.20% increase in rosuvastatin.
The HDL (high-density lipoprotein) cholesterol level of the pitavastatin group increased by 1.1 mg/dL, while the atorvastatin and rosuvastatin group only improved by 0.65 mg/dL and 0.38 mg/dL, respectively.
Recently, combination therapy of statin and ezetimibe is also recommended. In the case of monotherapy, the risk of side effects, such as muscle abnormalities and increased liver levels, as well as new diabetes, increases depending on the strength of the statin. However, if you take a combination of statin and ezetimibe, you can get the same lipid control effect as monotherapy while reducing the risk of side effects.
With these characteristics, a number of statin and ezetimibe combinations have been released, and the market size is also growing. According to UBIST, an outpatient drug market research institute, prescriptions for statin + ezetimibe complex increased by 68.1% from 474.6 billion won in 2020 to 797.6 billion won last year. In the first half of this year, prescriptions amounted to 471.7 billion won.
Reporter Park Yoon-jung ongoh@donga.com
2023-07-25 18:00:00
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