Risk of new onset diabetes mellitus with pitavastatin as compared to atorvastatin and rosuvastatin: a systematic review and meta-analysis

Statins are linked to the risk of new-onset diabetes mellitus (NODM). While atorvastatin and rosuvastatin are often associated with NODM, pitavastatin may carry a lower risk. This systematic review and meta-analysis (SRMA) evaluated the impact of pitavastatin on NODM compared to atorvastatin and rosuvastatin. We conducted a systematic literature search using PubMed, CENTRAL, EMBASE, and ClinicalTrials.gov. Two authors independently screened studies, assessed the risk of bias using Joanna Briggs Institute, Newcastle-Ottawa, and Scottish Intercollegiate Guidelines Network checklists, and extracted data. The analysis was performed using RevMan 5.4.1, and results were represented as risk ratios (RR) with 95% confidence intervals (CI) and heterogeneity was evaluated using the I2 statistic. Of 517 records screened, 13 studies were included, comprising observational studies, and randomized controlled trials. Most of the studies showed pitavastatin to be associated with a lower or no risk of NODM. Meta-analysis revealed that pitavastatin had a lower risk of NODM compared to atorvastatin (RR = 0.86, 95% CI = 0.79–0.93, p = 0.0002) and rosuvastatin (RR = 0.77, 95% CI = 0.71–0.84, p Pitavastatin poses a lower risk of NODM than other statins, making it a potentially safer option for patients requiring long-term statin therapy. www.crd.york.ac.uk/prospero identifier is CRD42022371741.