Cardio Round-up: Statins Not Effective In Half of Patients, Canagliflozin Performs, and More

This week’s edition includes some troubling findings for statins, good things happening with canagliflozin, a new add-on to SGLT-2 therapy, and a sigh of relief for those taking STELARA for psoriasis who were worried about additional cardiovascular risks.

In what is sure to be an unexpected development to many patients taking statins, a recent analysis published in Heart (BMJ) looked over 165,000 primary care patients free of cardiovascular disease prior to statin initiation from the UK Practice Research Datalink. The authors followed the patients out to two years, and looked at baseline LDL-C and at 24 months. Their analysis revealed that a staggering 51.2% of the patients (n=84,609) had a sub-optimal response to statin therapy. Those patients, the researchers cautioned, “will experience significantly increased risk for future cardiovascular disease.”

Canagliflozin (Invokana, Janssen) was recently featured in the CREDENCE trial, the manuscript of which was published in the New England Journal of Medicine (and presented at the recent International Society of Nephrology World Congress of Nephrology in Melbourne). The study population, consisting of 4,401 patients with type 2 diabetes and chronic kidney disease, was randomized to either canagliflozin 100 mg daily or placebo. Patients taking canagliflozin were 30% less likely than patients taking placebo to develop kidney failure or to die as a result of renal failure or cardiovascular disease. The trial was stopped early after a planned interim analysis showed sufficient efficacy in the treatment group. “A drug like canagliflozin that improves both cardiovascular and renal outcomes has been eagerly sought by both patients with type 2 diabetes and clinicians caring for them,” lead co-author Kenneth Mahaffey MD, of Stanford University, remarked.

Patients taking ustekinumab (STELARA) for psoriasis or psoriatic arthritis did not show any increased risk for atrial fibrillation or major adverse cardiovascular events. according to new study results published in JAMA Dermatology. The cohort study included over 60,000 patients with psoriasis or psoriatic arthritis from several databases who were taking either ustekinumab or a tumor necrosis factor inhibitor. The study outcomes of interest included incident atrial fibrillation and major adverse cardiovascular events (which includes myocardial infarction, stroke, or coronary revascualrization). According to the study results, there were no substantial differences in the risk for incident atrial fibrillation or MACE following ustekinumab initiation. “This information may be helpful when weighing risks and benefits of various systemic treatment strategies for psoriatic disease,” the researchers concluded.

Adding semaglutide (OZEMPIC, Novo Nordisk) to typical SGLT-2 therapy was associated with a significant improvement in glycemic control and a reduction in body weight in patients with inadequately controlled type 2 diabetes, according to new study results. The population included just over 300 partients with type 2 diabetes taking a weekly semaglutide add-on to their normal therapy. The results subverted that patients taking the add-on saw greater reductions in their HBA1c levels and body weight reductions versus the control group (P<0.0001 for both).