Intensive trumps standard statin therapy in severe diabetic retinopathy patients

Intensive statin therapy may be more beneficial than standard dosing for patients with severe diabetic retinopathy (DR), a recent study has found. In the overall population of DR patients, standard and intensive statin therapies have comparable impacts.

The present study was a sub-analysis of the multicentre, prospective, randomized study EMPATHY. A total of 157 EMPATHY participants were enrolled, of whom 85 and 72 received intensive and standard statin therapy, respectively. The primary study endpoint was a change of two steps in the Early Treatment Diabetic Retinopathy Study (ETDRS) DR severity scale after 36 months of treatment.

In the overall study sample, 20.0 percent and 14.1 percent of participants who received intensive and standard statin therapy, respectively, saw at least a two-step decrease in ETDRS DR severity. Corresponding rates for a two-step increase were 5.9 percent and 5.6 percent. These figures did not represent a between-group statistical difference (p=0.4380).

However, when looking at patients with severe DR, intensive statin treatment led to a significantly higher proportion of patients showing a one-step decrease in ETDRS DR grade vs standard therapy (83.3 percent vs 40.0 percent; p=0.0346).

“The intensive treatment tended to have greater effects on DR progression in patients with severe hard exudates at baseline. These findings suggest that using statins to achieve lower cholesterol levels might be beneficial in some but not in all patients with DR and hypercholesterolaemia,” the researchers said.

Future studies with larger cohorts are needed to identify the effects of intensive statin therapy in proliferative and nonproliferative DR complicated by hypercholesterolaemia, they added.