PCSK9 Inhibitors Not Linked to Short-Term Diabetes Risk
Short-term use of proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i) was not associated with an increased risk of developing type 2 diabetes, according to a recent meta-analysis presented at the European Society of Cardiology Congress.
In their meta-analysis, the researchers analyzed data from 15 randomized control trials with a total of 10,393 patients with primary hypercholesterolemia who were randomly assigned to receive PCSK9i or placebo with or without add-on statin therapy. The mean age of patients was 56±11 years, and 22% had type 2 diabetes. Patients were followed for a mean 1.16 years.
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Two independent reviewers assessed the study characteristics, quality, and data. Plasma glycosylated hemoglobin (HbA1c), fasting glucose, new onset diagnosis of type 2 diabetes, glucose intolerance, or worsening diabetes were assessed as the primary outcomes.
When compared with placebo, the researchers found that PCSK9i therapy did not significantly increase the risk for new onset or worsening diabetes, and did not affect fasting plasma glucose or HbA1c. However, meta-regression analyses showed that patients who experienced more intense low-density lipid cholesterol (LDL-C) reductions had a higher risk for developing type 2 diabetes.
“The small changes in fasting blood glucose and HbA1c in the short-term were not sufficient to increase the incidence of type 2 diabetes,” the authors concluded.2
“However, magnitude of LDL-C decrease during PCSK9 therapy is positively associated with the risk of [type 2 diabetes].”1
—Melissa Weiss
Reference:
1) Carvalho LSF, Campos AM, Sposito AC. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors and incident type 2 diabetes mellitus: a systematic review and meta-analysis with over 10,000 patients. Presented at: 2017 European Society of Cardiology Congress; August 26-30, 2017; Barcelona, ES. Abstract: 5966.
2) Meta-analysis suggests PCSK9 inhibitors do not increase short-term risk of type 2 diabetes [press release]. Barcelona, ES: European Society of Cardiology, August 29, 2017. https://www.escardio.org/The-ESC/Press-Office/Press-releases/meta-analysis-suggests-pcsk9-inhibitors-do-not-increase-short-term-risk-of-type-2-diabetes.