Title

LIpid Lowering With Highly Potent Statins in Hyperlipidaemia With Type 2 Diabetes patiENts
Study on Effect of Highly Potent Statins on Lipid Lowering Effect and Glucose Metabolism in Hypercholesterolemia Patients With Diabetes Mellitus
  • Phase

    N/A
  • Study Type

    Interventional
  • Study Participants

    1049
The purpose of this study is to compare the effect of rosuvastatin and atorvastatin on lipid lowering effect and glucose metabolism in hypercholesterolemia patients with diabetes mellitus.
Study Started
Mar 31
2012
Primary Completion
Jun 30
2014
Results Posted
Mar 17
2015
Estimate
Last Update
Mar 17
2015
Estimate

Drug Atorvastatin

Atorvastatin 10 mg (atorvastatin 10 mg tablet x 1 or atorvastatin 5 mg tablet x 2), orally,once daily for 12 months. (When not reach the LDL-C level of target in the Japan Atherosclerosis Society [JAS] Guidelines [GL] after 3 months, had the atorvastatin [ATV] dose of 20 mg.)

  • Other names: Lipitor

Drug Rosuvastatin

Rosuvastatin 5 mg (rosuvastatin 5 mg tablet x1 or rosuvastatin 2.5 mg tablet x 2), orally, once daily for 12 months. (When not reach the LDL-C level of target in JAS GL after 3 months, had the rosuvastatin [RSV] dose of 10 mg.)

  • Other names: Crestor

Atorvastatin administration group Experimental

Rosuvastatin administration group Experimental

Criteria

Inclusion Criteria:

Hypercholesterolemia patients

• Patients who have not achieved the target control levels of LDL-C in the "Japan Atherosclerosis Society Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2007"

Type 2 diabetes patients

Patients diagnosed with type 2 diabetes and receiving diet therapy, exercise therapy, or medication
Patients who received constant therapy for three months before registration and have no plan for therapy change
Patients with kept HbA1c level (Japan Diabetes Society [JDS] level) of less than 7.0% (or, National Glycohemoglobin Standardization Program [NGSP] level of less than 7.4%) within three months before registration
Patients receiving or not receiving medication at present
Patients giving voluntary written consent to participate in the study
Male or female patients at 20 years or older

Exclusion Criteria:

Patients who administered rosuvastatin, atorvastatin or ezetimibe within three month at the registration
Patients with severe hypertension (systolic blood pressure [SBP] ≥ 180 mmHg or diastolic blood pressure [DBP] ≥ 110 mmHg)
Patients with type 1 diabetes
Patients judged to have familial hypercholesterolemia
Patients with a serum triglyceride level of ≥ 400 mg/dL
Patients who had the onset of cardiovascular or cerebrovascular disease within three months
Patients with serious heart failure (NYHA classification III - IV)
Patients with a history of hypersensitivity to statins
Patients with a history of drug-induced myopathy
Patients with severe complication of diabetes
Patients receiving insulin
Patients with serious liver or kidney disease
Patients with serious concurrent disease such as malignancy, or patients with severely limited lifespan
Patients who are or may be pregnant
Patients judged by the investigators to be ineligible for participation in the study for any other reason

Summary

Atorvastatin Administration Group

Rosuvastatin Administration Group

All Events

Event Type Organ System Event Term Atorvastatin Administration Group Rosuvastatin Administration Group

Percent Change in Non-high-density Lipoprotein Cholesterol (HDL-C) Level

Atorvastatin Administration Group

-31.3
Percent change (Mean)
Standard Deviation: 19.1

Rosuvastatin Administration Group

-32.8
Percent change (Mean)
Standard Deviation: 18.1

Change in HbA1c Level

Atorvastatin Administration Group

0.12
Amount of change (%) (Mean)
Standard Deviation: 0.65

Rosuvastatin Administration Group

0.1
Amount of change (%) (Mean)
Standard Deviation: 0.67

Occurrence of Deterioration of Diabetic Treatment Status

"Deterioration of diabetic treatment status" is defined as addition of new drug, increase in dosage, drug changes (therapy intensification), and deterioration in HbA1c of > 0.5%.

Atorvastatin Administration Group

Deterioration in HbA1c of > 0.5%

177.0
Participants

Therapy intensification

64.0
Participants

Rosuvastatin Administration Group

Deterioration in HbA1c of > 0.5%

162.0
Participants

Therapy intensification

45.0
Participants

Number of Participants Stratified by Time to the Occurrence of Deterioration of Diabetic Treatment Status

"Deterioration of diabetic treatment status" is defined as addition of new drug, increase in dosage, drug changes (therapy intensification), and deterioration in HbA1c of > 0.5%.

Atorvastatin Administration Group

No deterioration

421.0
participants

Other: 0-3 months

6.0
participants

Other: 3-6 months

5.0
participants

Other: 6-12 months

8.0
participants

Therapy intensification: 0-3 months

20.0
participants

Therapy intensification: 3-6 months

12.0
participants

Therapy intensification: 6-12 months

32.0
participants

Rosuvastatin Administration Group

No deterioration

453.0
participants

Other: 0-3 months

5.0
participants

Other: 3-6 months

5.0
participants

Other: 6-12 months

6.0
participants

Therapy intensification: 0-3 months

14.0
participants

Therapy intensification: 3-6 months

8.0
participants

Therapy intensification: 6-12 months

23.0
participants

Percent Change in 1,5-AG Level

An inverse relationship exists between mean change in 1,5-AG level and the mean rate of change when the degree of standard deviation is large, wherein the mean change is negative although the mean rate of change is positive or vice versa

Atorvastatin Administration Group

At 12 months

-3.8
Percent change (Mean)
Standard Deviation: 35.1

At 3 months

-1.6
Percent change (Mean)
Standard Deviation: 30.8

At 6 months

-6.5
Percent change (Mean)
Standard Deviation: 35.8

Rosuvastatin Administration Group

At 12 months

3.5
Percent change (Mean)
Standard Deviation: 98.0

At 3 months

5.5
Percent change (Mean)
Standard Deviation: 72.6

At 6 months

2.6
Percent change (Mean)
Standard Deviation: 83.7

Change in HbA1c Level

Atorvastatin Administration Group

At 3 months

0.05
Amount of change (%) (Mean)
Standard Deviation: 0.42

At 6 months

0.13
Amount of change (%) (Mean)
Standard Deviation: 0.57

Rosuvastatin Administration Group

At 3 months

At 6 months

0.12
Amount of change (%) (Mean)
Standard Deviation: 0.65

Percent Change in Blood Glucose Level (Fasting)

Atorvastatin Administration Group

At 12 months

4.6
Percent change (Mean)
Standard Deviation: 24.3

At 3 months

3.3
Percent change (Mean)
Standard Deviation: 19.3

At 6 months

7.0
Percent change (Mean)
Standard Deviation: 24.1

Rosuvastatin Administration Group

At 12 months

3.7
Percent change (Mean)
Standard Deviation: 26.1

At 3 months

2.7
Percent change (Mean)
Standard Deviation: 25.0

At 6 months

5.9
Percent change (Mean)
Standard Deviation: 25.7

Change in Blood Glucose Level (Fasting)

Atorvastatin Administration Group

At 12 months

3.6
mg/dL (Mean)
Standard Deviation: 30.7

At 3 months

2.6
mg/dL (Mean)
Standard Deviation: 24.5

At 6 months

6.8
mg/dL (Mean)
Standard Deviation: 30.2

Rosuvastatin Administration Group

At 12 months

1.5
mg/dL (Mean)
Standard Deviation: 35.0

At 3 months

0.1
mg/dL (Mean)
Standard Deviation: 31.2

At 6 months

4.3
mg/dL (Mean)
Standard Deviation: 31.5

Percent Change in Insulin Level

An inverse relationship exists between mean change in insulin level and the mean rate of change when the degree of standard deviation is large, wherein the mean change is negative although the mean rate of change is positive or vice versa.

Atorvastatin Administration Group

At 12 months

17.4
Percent change (Mean)
Standard Deviation: 132.9

At 3 months

40.7
Percent change (Mean)
Standard Deviation: 211.2

At 6 months

45.1
Percent change (Mean)
Standard Deviation: 193.9

Rosuvastatin Administration Group

At 12 months

13.8
Percent change (Mean)
Standard Deviation: 148.1

At 3 months

31.3
Percent change (Mean)
Standard Deviation: 166.4

At 6 months

35.5
Percent change (Mean)
Standard Deviation: 142.8

Change From Baseline in Insulin Level

An inverse relationship exists between mean change in insulin level and the mean rate of change when the degree of standard deviation is large, wherein the mean change is negative although the mean rate of change is positive or vice versa

Atorvastatin Administration Group

At 12 months

-1.5
μU/mL (Mean)
Standard Deviation: 18.69

At 3 months

-0.1
μU/mL (Mean)
Standard Deviation: 20.26

At 6 months

0.66
μU/mL (Mean)
Standard Deviation: 18.63

Baseline Insulin level

10.95
μU/mL (Mean)
Standard Deviation: 18.66

Rosuvastatin Administration Group

At 12 months

-2.91
μU/mL (Mean)
Standard Deviation: 19.02

At 3 months

-0.54
μU/mL (Mean)
Standard Deviation: 18.56

At 6 months

-0.44
μU/mL (Mean)
Standard Deviation: 19.86

Baseline Insulin level

12.57
μU/mL (Mean)
Standard Deviation: 20.07

Frequency of Cardiovascular Events (Coronary Artery Disease, Heart Failure, Cerebrovascular Disease, Peripheral Artery Disease and Aortic Disease)

Atorvastatin Administration Group

5.0
Number of patients with any events

Rosuvastatin Administration Group

9.0
Number of patients with any events

Frequency of Serious Adverse Events (SAE)

Atorvastatin Administration Group

14.0
Number of patients with SAE

Rosuvastatin Administration Group

19.0
Number of patients with SAE

Percent Changes in Lipids (LDL-C, HDL-C, TC, TG, Non-HDL-C/HDL-C Ratio, and FFA)

Atorvastatin Administration Group

FFA: at 12 months

37.2
Percent change (Mean)
Standard Deviation: 125.3

FFA: at 3 months

19.9
Percent change (Mean)
Standard Deviation: 87.8

FFA: at 6 months

13.8
Percent change (Mean)
Standard Deviation: 80.5

HDL-C: at 12 months

4.9
Percent change (Mean)
Standard Deviation: 14.7

HDL-C: at 3 months

4.1
Percent change (Mean)
Standard Deviation: 14.3

HDL-C: at 6 months

7.1
Percent change (Mean)
Standard Deviation: 15.1

LDL-C: at 12 months

-33.2
Percent change (Mean)
Standard Deviation: 21.5

LDL-C: at 3 months

-36.6
Percent change (Mean)
Standard Deviation: 19.2

LDL-C: at 6 months

-35.6
Percent change (Mean)
Standard Deviation: 19.4

Non-HDL-C/HDL-C ratio: at 12 months

-33.1
Percent change (Mean)
Standard Deviation: 22.7

Non-HDL-C/HDL-C ratio: at 3 months

-34.8
Percent change (Mean)
Standard Deviation: 22.6

Non-HDL-C/HDL-C ratio: at 6 months

-36.1
Percent change (Mean)
Standard Deviation: 19.4

TC: at 12 months

-22.7
Percent change (Mean)
Standard Deviation: 14.3

TC: at 3 months

-24.7
Percent change (Mean)
Standard Deviation: 13.3

TC: at 6 months

-23.5
Percent change (Mean)
Standard Deviation: 13.0

TG: at 12 months

-12.6
Percent change (Mean)
Standard Deviation: 62.2

TG at 3 months

-12.7
Percent change (Mean)
Standard Deviation: 38.0

TG: at 6 months

-12.4
Percent change (Mean)
Standard Deviation: 45.9

Rosuvastatin Administration Group

FFA: at 12 months

34.8
Percent change (Mean)
Standard Deviation: 111.0

FFA: at 3 months

25.9
Percent change (Mean)
Standard Deviation: 111.3

FFA: at 6 months

15.9
Percent change (Mean)
Standard Deviation: 88.9

HDL-C: at 12 months

7.7
Percent change (Mean)
Standard Deviation: 15.9

HDL-C: at 3 months

5.6
Percent change (Mean)
Standard Deviation: 13.9

HDL-C: at 6 months

8.2
Percent change (Mean)
Standard Deviation: 15.2

LDL-C: at 12 months

-34.7
Percent change (Mean)
Standard Deviation: 21.0

LDL-C: at 3 months

-39.2
Percent change (Mean)
Standard Deviation: 21.3

LDL-C: at 6 months

-36.4
Percent change (Mean)
Standard Deviation: 21.8

Non-HDL-C/HDL-C ratio: at 12 months

-36.0
Percent change (Mean)
Standard Deviation: 20.7

Non-HDL-C/HDL-C ratio: at 3 months

-37.7
Percent change (Mean)
Standard Deviation: 20.2

Non-HDL-C/HDL-C ratio: at 6 months

-37.2
Percent change (Mean)
Standard Deviation: 20.8

TC: at 12 months

-23.5
Percent change (Mean)
Standard Deviation: 14.0

TC: at 3 months

-25.9
Percent change (Mean)
Standard Deviation: 14.3

TC: at 6 months

-23.8
Percent change (Mean)
Standard Deviation: 14.9

TG: at 12 months

-15.9
Percent change (Mean)
Standard Deviation: 35.4

TG at 3 months

-11.0
Percent change (Mean)
Standard Deviation: 42.2

TG: at 6 months

-11.9
Percent change (Mean)
Standard Deviation: 38.0

Percent Change in Non-HDL-C Level

Atorvastatin Administration Group

At 3 months

-33.8
Percent change (Mean)
Standard Deviation: 17.6

At 6 months

-33.2
Percent change (Mean)
Standard Deviation: 16.6

Rosuvastatin Administration Group

At 3 months

-35.5
Percent change (Mean)
Standard Deviation: 18.4

At 6 months

-33.5
Percent change (Mean)
Standard Deviation: 18.8

Percent Changes in Lipids and Inflammatory Marker (Hs-CRP) and Their Correlation

Correlation between percent changes in lipids (LDL-C, HDL-C, non-HDL-C, TG, non-HDL-C/HDL-C ratio, LDL-C/HDL-C ratio, TC and FFA) and inflammatory marker (hs-CRP)

Outcome Measure Data Not Reported

Rate of Patients Who Have Reached the Target LDL-C Level Specified in Japan Atherosclerosis Society Guidelines (JASGL) 2007

Percentage of participants achieving the target LDL-C levels <100 mg/dL for participants with history of coronary artery diseases (CAD) and <120 mg/dL for participants without history of CAD are presented.

Atorvastatin Administration Group

At 3 months

89.0
Percentage of participants
95% Confidence Interval: 85.5 to 92.0

At the end of study treatment

86.3
Percentage of participants
95% Confidence Interval: 82.5 to 89.6

Rosuvastatin Administration Group

At 3 months

89.9
Percentage of participants
95% Confidence Interval: 86.3 to 92.8

At the end of study treatment

87.5
Percentage of participants
95% Confidence Interval: 83.7 to 90.7

Change From Baseline in 1,5-AG Level

An inverse relationship exists between mean change in 1,5-AG level and the mean rate of change when the degree of standard deviation is large, wherein the mean change is negative although the mean rate of change is positive or vice versa

Atorvastatin Administration Group

At 12 months

-0.88
μg/mL (Mean)
Standard Deviation: 4.33

At 3 months

-0.51
μg/mL (Mean)
Standard Deviation: 3.48

At 6 months

-1.28
μg/mL (Mean)
Standard Deviation: 4.23

Baseline 1,5-AG level

15.4
μg/mL (Mean)
Standard Deviation: 7.91

Rosuvastatin Administration Group

At 12 months

-1.09
μg/mL (Mean)
Standard Deviation: 4.66

At 3 months

-0.21
μg/mL (Mean)
Standard Deviation: 3.77

At 6 months

-0.94
μg/mL (Mean)
Standard Deviation: 4.64

Baseline 1,5-AG level

15.39
μg/mL (Mean)
Standard Deviation: 8.10

Total

1018
Participants

1,5-anhydro-D-glucitol (1,5-AG)

15.40
μg/mL (Mean)
Standard Deviation: 8.01

Age, Continuous

66.4
years (Mean)
Standard Deviation: 11.1

Blood glucose

118.9
mg/dL (Mean)
Standard Deviation: 29.2

Free fatty acids (FFA)

0.584
mEq/L (Mean)
Standard Deviation: 0.298

HbA1c

6.39
% (NGSP value) (Mean)
Standard Deviation: 0.63

HDL-C

54.9
mg/dL (Mean)
Standard Deviation: 14.1

Insulin

11.77
μU/mL (Mean)
Standard Deviation: 19.39

LDL-C/HDL-C ratio

2.69
ratio (Mean)
Standard Deviation: 0.86

Low-density lipoprotein cholesterol (LDL-C)

139.4
mg/dL (Mean)
Standard Deviation: 30.0

Non-HDL-C/HDL-C ratio

3.30
ratio (Mean)
Standard Deviation: 1.20

Non-high-density lipoprotein cholesterol (HDL-C)

168.9
mg/dL (Mean)
Standard Deviation: 33.3

Total cholesterol (TC)

223.9
mg/dL (Mean)
Standard Deviation: 34.0

Triglyceride (TG)

152.1
mg/dL (Mean)
Standard Deviation: 115.8

Angina pectoris

Cardiac arrhythmias

Cardiovascular and Cerebrovascular events before entry

Cerebral haemorrhage

Cerebral infarction

Complications related to diabetes

Diabetic foot

Diabetic nephropathy

Diabetic neuropathy

Diabetic retinopathy

Heart failure

Hypertension

Myocardial infarction

Revascularization

Sex/Gender, Customized

Statin administration before entry

Transient ischaemic attack

Overall Study

Atorvastatin Administration Group

Rosuvastatin Administration Group

Drop/Withdrawal Reasons

Atorvastatin Administration Group

Rosuvastatin Administration Group