Breakthrough: A daily dose of a cholesterol-lowering drug can halve the risk of stroke in patients with diabetes and cut cardiovascular events, including heart attacks, by more than a third, according to new research.
In a study being hailed by diabetes clinicians as a major treatment breakthrough, the cholesterol-fighter Lipitor - known generically as atorvastatin - was proven to have clear benefits for patients with type II diabetes, regardless of their cholesterol levels.
The study, which was carried out on 2,800 British and Irish patients with predominantly low cholesterol levels, showed a daily 10mg dose of atorvastatin reduced the risk of a major cardiovascular event by 37 per cent. Serious heart problems were reduced by 36 per cent and strokes by 48 per cent - it is estimated that this approach will save hundreds of Irish lives a year.
Prof Helen Colhoun, professor of genetic epidemiology at University College Dublin, said the treatment was already licensed in the Republic, where an estimated 6 per cent of the population, or more than 200,000 people, had type II diabetes.
"The main barrier is information. Patients need to be informed and clinicians convinced that this is really important," she told The Irish Times.
"The key message for people with diabetes is 'don't think you don't need this drug because your cholesterol level isn't high'."
She noted that prescribing the €1-a-shot drug manufactured by Pfizer to all type II diabetes patients would have a cost implication. But, she said, it would more than pay for itself through a reduction in heart attacks and strokes which account for a "huge burden" of costs in the health sector.
From a clinical point of view, she said, "the challenge is really whether there is anybody with type II diabetes at sufficiently low risk of heart disease not to warrant this treatment".
Prof John Nolan, head of the diabetes unit at St James's Hospital, which contributed 34 patients to the research project, also welcomed the "landmark" study. He said three-quarters of people with diabetes die of heart disease, or die early.
People with type II diabetes are between two and four times more likely to have a heart attack or a stroke.
"This study is of major importance, especially for a country like Ireland where rates of diabetes are increasing rapidly because of an increase in obesity," he said.
The findings from the seven-year Lipitor study, which were presented at the annual meeting of the American Diabetes Association in Orlando, Florida at the weekend, add to the growing body of evidence favouring cholesterol-lowering drugs, or statins, in the treatment of diabetes.
A similar study last year on Merck & Co statin Zocor showed it cut the risk of heart attack and stroke by a third. And it was already clear last June that Lipitor was having a significant impact when the British and Irish trial was halted two years early to allow patients on placebo to take the drug.
The full results of the CARDS (Collaborative AtoRvastatin Diabetes Study) study - which was sponsored by British charity Diabetes UK, Britain's Department of Health and Pfizer UK - will be published in the journal Diabetic Medicine next month.
St Michael's Hospital, Dún Laoghaire was among 131 other centres to participate in the research project.
Market analysts believe the study could provide a boost to the manufacturers of statins - already the world's top-selling medicines. Lipitor has annual sales of $10 billion (€8.14 billion), and could potentially sell to a worldwide market of 194 million diabetics, only a small fraction of whom currently take statins.
