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High-Dose Atorvastatin Is a "Clinically Meaningful Intervention" for Diabetic Foot Ulcers

Posted: Wednesday, October 28, 2009

High-dose atorvastatin may reduce the incidence and recurrence of foot ulcers in diabetic patients, according to a new report.

Lead author Dr. Odd Erik Johansen stated that, "This is a major medical contribution for subjects prone to develop this devastating complication.... This could be the first clinically meaningful single-agent intervention for the prevention of diabetic foot ulcers."

Dr. Johansen, of Asker and Baerum Hospital, Rud, Norway, and colleagues examined the effects of low and high doses of atorvastatin on the healing and recurrence of diabetic foot ulcers in 13 patients, 10 of whom had Type 2 diabetes.

Their mean duration of diabetes was 18 years, and their ulcers had persisted for no more than 4 months.

After randomization, 6 subjects (6 ulcers) took 10 mg of atorvastatin daily and 7 subjects (9 ulcers) took 80 mg/day. Everyone also received conventional management, including debridement, pressure relief, and antibiotics for underlying infections. There was no difference in ulcer characteristics or antibiotic use between the groups.

In the low-dose group, all 6 ulcers healed over a median of 49 days. In the high-dose group, 6 of 9 ulcers healed over a median of 89 days.

In the low-dose group, however, 2 healed ulcers recurred at 60 and 86 days after healing, and 6 new ulcers developed within a median of 108 days from baseline. There were no recurrences in the high-dose group, and only one new ulcer at 91 days from baseline.

The authors point out that the difference between groups in the incidence of recurring or new ulcers -- 8 versus 1 -- was statistically significant (p=0.048).

Changes in lipid parameters were similar between the groups, with the exceptions of a significant decrease in C-reactive protein (p = 0.044) in the high-dose group. This group also had a non-significant trend toward improvement in ankle-brachial pressure index.

Dr. Johansen stated that, "High-dose statins should be used more liberally among subjects susceptible to develop diabetic foot ulcer."

Source: Diabetes In Control: J Diabetes Sept.2009;1:182-187.

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