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

Background: 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. Methods: 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 I-2 statistic. Results: 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 < 0.00001). Conclusion: Pitavastatin poses a lower risk of NODM than other statins, making it a potentially safer option for patients requiring long-term statin therapy. Protocol registration: www.crd.york.ac.uk/prospero identifier is CRD42022371741.