EDMONTON, Alberta -- October 27, 2009 -- More than 80% of patients with type 2 diabetes can reach a low-density lipoprotein (LDL) cholesterol target of <2.0 mmol/L with a single uptitration of rosuvastatin if initiated on an appropriate starting dose, according to a study presented here at the 2009 Canadian Cardiovascular Congress (CCC).
David C.W. Lau, MD, Department of Endocrinology, University of Calgary, Calgary, Alberta, presented the results of the multicentre, open-label A Diabetes Study to Treat a Population Previously Not at Target (ADAPT) on October 25.
"The tested algorithm was designed to be very simple," said Dr. Lau. "We wanted to show that it is easy to get patients to goal if you start with adequate therapy."
For the study, Dr. Lau and colleagues enrolled patients with type 2 diabetes who were not at the current Canadian Diabetes Association goal of <2.0 mmol/L despite at least 4 weeks on a conventional statin regimen.
In the algorithm, those with a baseline LDL cholesterol level of >2.0 but <2.5 mmol/L were initiated on rosuvastatin 10 mg. If the baseline LDL cholesterol level was >2.5 mmol/L, the starting rosuvastatin dose was 20 mg. If the target was not reached at 6 weeks, the dose in each group was doubled.
At the end of 12 weeks, 84% of those initiated on 10 mg and 79% of those initiated on 20 mg of rosuvastatin were at goal (82% overall). The average LDL at the end of 12 weeks of therapy was 1.7 mmol/L. Of those at LDL goal, 90% had also achieved the apolipoprotein B target of <0.8 g/L.
There were no side effects associated with treatment and no cases of elevated liver enzymes (>3 times upper limit of normal) or muscle enzymes (>10 times upper limit of normal).
"These are real-world results," reported Dr. Lau, who said that the study was conducted specifically in the family practice setting to show efficacy in routine patient care.
He reported that the absence of any safety issues is consistent with previous studies and supports the premise of using adequate doses of statins from the start when trying to reach current treatment goals.
CCC is co-hosted by the Canadian Cardiovascular Society and the Heart and Stroke Foundation of Canada.
[Presentation title: ADAPT Study: Algorithm Based Therapy to Reduce the Lipid Treatment Gap in Type 2 Diabetes. Abstract 157]
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