Articles producció científica> Medicina i Cirurgia

Impact of PCSK9 inhibitors in glycaemic control and new-onset diabetes

  • Dades identificatives

    Identificador: imarina:9333931
    Autors:
    González-Lleó, AMSánchez-Hernández, RMPlana, NIbarretxe, DRehues, PRibalta, JLlop, DWägner, AMMasana, LBoronat, M
    Resum:
    The diabetogenic effect of statins has been well established by clinical trials, Mendelian randomisation studies and meta-analyses. According to large clinical trials, PCSK9 inhibitors (PCSK9i) have no deleterious impact on glucose metabolism. However, few real-life studies have yet evaluated the long-term effects of these drugs on glucose homeostasis and their impact on new-onset diabetes (NODM).We studied 218 patients treated with either alirocumab or evolocumab (70% with familial hypercholesterolemia) for at least three years (PCSK9iG). We studied the NODM rate in the nondiabetic group at baseline (168) and overall glucose metabolism control in the whole group. Incidental DM was compared with two groups. The first was a propensity score matching (PSM)-selected group (n = 168) from the database of patients attending the Reus lipid unit (Metbank, n = 745) who were not on PCSK9i (PSMG). The second was a subgroup with a similar age range (n = 563) of the Di@bet.es study (Spanish prospective study on diabetes development n = 5072) (D@G). The incidence was reported as the percentage of NODM cases per year.The fasting glucose (FG) level of the subjects with normoglycaemia at baseline increased from 91 (86-95.5) to 93 (87-101) mg/dL (p = 0.014). There were 14 NODM cases in the PCSK9i group (2.6%/y), all among people with prediabetes at baseline. The incidence of NODM in PSMG and D@G was 1.8%/y (p = 0.69 compared with the PCSK9iG). The incidence among the subjects with prediabetes was 5.1%/y in the PCSK9iG, 4.8%/y in the PSMG and 3.9%/y in the D@G (p = 0.922 and p = 0.682, respectively). In the multivariate analysis, only the FG level was associated with the development of NODM in the PCSK9iG (OR 1.1; 95% CI: 1.0-1.3; p = 0.027). Neither FG nor A1c levels changed significantl
  • Altres:

    Autor segons l'article: González-Lleó, AM; Sánchez-Hernández, RM; Plana, N; Ibarretxe, D; Rehues, P; Ribalta, J; Llop, D; Wägner, AM; Masana, L; Boronat, M
    Departament: Medicina i Cirurgia
    Autor/s de la URV: Ibarretxe Gerediaga, Daiana / Llop Paredes, Dídac / Masana Marín, Luis / Plana Gil, Núria / Rehues Masip, Pere / Ribalta Vives, Josep
    Paraules clau: Real-life study Prediabetes Pcsk9 inhibitors New-onset diabetes mellitus Hyperglycaemia Familial hypercholesterolemia Alirocumab safety risk real-life study prediabetes pcsk9 inhibitors hyperglycaemia familial hypercholesterolemia efficacy association
    Resum: The diabetogenic effect of statins has been well established by clinical trials, Mendelian randomisation studies and meta-analyses. According to large clinical trials, PCSK9 inhibitors (PCSK9i) have no deleterious impact on glucose metabolism. However, few real-life studies have yet evaluated the long-term effects of these drugs on glucose homeostasis and their impact on new-onset diabetes (NODM).We studied 218 patients treated with either alirocumab or evolocumab (70% with familial hypercholesterolemia) for at least three years (PCSK9iG). We studied the NODM rate in the nondiabetic group at baseline (168) and overall glucose metabolism control in the whole group. Incidental DM was compared with two groups. The first was a propensity score matching (PSM)-selected group (n = 168) from the database of patients attending the Reus lipid unit (Metbank, n = 745) who were not on PCSK9i (PSMG). The second was a subgroup with a similar age range (n = 563) of the Di@bet.es study (Spanish prospective study on diabetes development n = 5072) (D@G). The incidence was reported as the percentage of NODM cases per year.The fasting glucose (FG) level of the subjects with normoglycaemia at baseline increased from 91 (86-95.5) to 93 (87-101) mg/dL (p = 0.014). There were 14 NODM cases in the PCSK9i group (2.6%/y), all among people with prediabetes at baseline. The incidence of NODM in PSMG and D@G was 1.8%/y (p = 0.69 compared with the PCSK9iG). The incidence among the subjects with prediabetes was 5.1%/y in the PCSK9iG, 4.8%/y in the PSMG and 3.9%/y in the D@G (p = 0.922 and p = 0.682, respectively). In the multivariate analysis, only the FG level was associated with the development of NODM in the PCSK9iG (OR 1.1; 95% CI: 1.0-1.3; p = 0.027). Neither FG nor A1c levels changed significantly in patients with DM at baseline.A nonsignificant increase in NODM occurred in the PCSK9iG, particularly in patients with prediabetes, compared with the PSMG and D@G groups. Baseline FG levels were the main variable associated with the development of DM. In the subjects who had DM at baseline, glucose control did not change. The impact of PCSK9i on glucose metabolism should not be of concern when prescribing these therapies.© 2023. The Author(s).
    Àrees temàtiques: Saúde coletiva Medicina ii Medicina i Internal medicine Interdisciplinar Farmacia Endocrinology, diabetes and metabolism Endocrinology & metabolism Educação física Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems Biotecnología
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: pere.rehues@urv.cat didac.llop@urv.cat daiana.ibarretxe@urv.cat didac.llop@urv.cat pere.rehues@urv.cat luis.masana@urv.cat josep.ribalta@urv.cat
    Identificador de l'autor: 0000-0002-0789-4954 0000-0002-8879-4719
    Data d'alta del registre: 2024-09-14
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Enllaç font original: https://cardiab.biomedcentral.com/articles/10.1186/s12933-023-02077-y
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referència a l'article segons font original: Cardiovascular Diabetology. 23 (1): 4-4
    Referència de l'ítem segons les normes APA: González-Lleó, AM; Sánchez-Hernández, RM; Plana, N; Ibarretxe, D; Rehues, P; Ribalta, J; Llop, D; Wägner, AM; Masana, L; Boronat, M (2024). Impact of PCSK9 inhibitors in glycaemic control and new-onset diabetes. Cardiovascular Diabetology, 23(1), 4-4. DOI: 10.1186/s12933-023-02077-y
    DOI de l'article: 10.1186/s12933-023-02077-y
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2024
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine,Endocrinology & Metabolism,Endocrinology, Diabetes and Metabolism,Internal Medicine
    Real-life study
    Prediabetes
    Pcsk9 inhibitors
    New-onset diabetes mellitus
    Hyperglycaemia
    Familial hypercholesterolemia
    Alirocumab
    safety
    risk
    real-life study
    prediabetes
    pcsk9 inhibitors
    hyperglycaemia
    familial hypercholesterolemia
    efficacy
    association
    Saúde coletiva
    Medicina ii
    Medicina i
    Internal medicine
    Interdisciplinar
    Farmacia
    Endocrinology, diabetes and metabolism
    Endocrinology & metabolism
    Educação física
    Ciências biológicas ii
    Ciências biológicas i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
    Biotecnología
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