The medical letter on drugs and therapeutics september 1 2014

The Medical Letter ® on Drugs and Therapeutics Objective Drug Reviews Since 1959 Volume 56 ISSUE ISSUE No 1433 1450 Volume 56 September 1, 2014 IN THIS ISSUE Statins and Diabetes Risk p 79 Drugs for Osteoarthritis p 80 In Brief: New Polio Vaccination Guidance for Travelers p 84 Important Copyright Message FORWARDING OR COPYING IS A VIOLATION OF U.S AND INTERNATIONAL COPYRIGHT LAWS The Medical Letter, Inc publications are protected by U.S and international copyright laws Forwarding, copying or any distribution of this material is prohibited Sharing a password with a non-subscriber or otherwise making the contents of this site available to third parties is strictly prohibited By accessing and reading the attached content I agree to comply with U.S and international copyright laws and these terms and conditions of The Medical Letter, Inc For further information click: Subscriptions, Site Licenses, Reprints or call customer service at: 800-211-2769 Published by The Medical Letter, Inc • A Nonprofit Organization The Medical Letter publications are protected by US and international copyright laws Forwarding, copying or any other distribution of this material is strictly prohibited For further information call: 800-211-2769 The Medical Letter ® on Drugs and Therapeutics Objective Drug Reviews Since 1959 Volume 56 ISSUE ISSUE No 1433 1450 Volume 56 ▶ September 1, 2014 Take CME Exams ALSO IN THIS ISSUE Drugs for Osteoarthritis p 80 In Brief: New Polio Vaccination Guidance for Travelers p 84 Statins and Diabetes Risk In 2012, the FDA required manufacturers of HMG-CoA reductase inhibitors (statins) to add a warning to their labels about reports of increased blood glucose and glycosylated hemoglobin (HbA1c) levels.1 Since then, several new studies have been published MECHANISM — No mechanism for a diabetogenic effect of statins has been established Some investigators have proposed that statins may cause an immune response that interferes with insulin signaling.2 NEW-ONSET DIABETES RISK — A meta-analysis of primary or secondary cardiovascular prevention studies in a total of 51,619 non-diabetic patients, with median follow-up times ranging from 1.9-5.0 years, found that 4.0% of patients taking statins and 3.5% of those taking placebo developed diabetes.3 In another meta-analysis of 13 studies that included a total of 91,140 non-diabetic patients, new-onset diabetes occurred 9% more frequently among those taking statins than among those not taking statins.4 Both differences were statistically significant In one large placebo-controlled primary prevention trial, the increased risk of diabetes with rosuvastatin 20 mg was confined to patients with at least one major risk factor for the disease.5 A cohort study examined the relationship between statin adherence rate and diabetes incidence in 115,709 non-diabetic 40- to 80-year-old patients Compared to patients with adherence rates of