Impact of PCSK9 inhibitors in glycaemic control and new-onset diabetes
Authors' conclusion
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.
Study context
- Population
- Patients treated with PCSK9 inhibitors (PCSK9i) for ≥3 years (70% familial hypercholesterolemia); NODM assessed in those nondiabetic at baseline (168)
- Participants
- 218 / 168 / 563
- Exposure
- PCSK9i (alirocumab or evolocumab) vs propensity-matched lipid-unit patients not on PCSK9i and Di@bet.es subgroup
- PCSK9iGn = 218
- PSMGn = 168reference
- D@Gn = 563reference
- Outcome
- NODM incidence in nondiabetic at baseline (% of cases per year)
Methodological detailsreal-life, propensity score matching comparison group, comparison with population cohort (Di@bet.es)
- Real-life
- Propensity score matching comparison group
- Comparison with population cohort (Di@bet.es)
Main finding
As reported in the abstract
PCSK9i
2.6%/y
14 events
PSMG
1.8%/y
D@G
1.8%/y
P = 0.69
Observational data: associations, not effects.
Further findings
Baseline fasting glucose (FG) associated with NODM in PCSK9iG (multivariate)
| OR (95% CI) | P value | ||
|---|---|---|---|
| FG levelMultivariate analysis | 1.1 (1.0–1.3) | P = 0.027 | |
| 0.512Odds ratio (log scale) |
| Outcome | PCSK9iG | PSMG | D@G | P value |
|---|---|---|---|---|
| NODM incidence in prediabetesPCSK9iG vs PSMG | 5.1%/y | 4.8%/y | 3.9%/y | P = 0.922 |
| NODM incidence in prediabetesPCSK9iG vs D@G | P = 0.682 |
Fasting glucose in normoglycaemic subjects at baseline (PCSK9iG) · baseline to follow-up
- FG increased from 91 (86-95.5) to 93 (87-101) mg/dL
- P = 0.014
FG and A1c in patients with DM at baseline
- Neither FG nor A1c levels changed significantly
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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