A meta-analysis of 20 randomized controlled trials examined how various lipid-lowering medications affect patients with diabetic kidney disease and high cholesterol. The study compared cerivastatin, simvastatin, atorvastatin, rosuvastatin, and fenofibrate.
For total cholesterol, cerivastatin was the most effective, reducing levels by about 94 points on average. Simvastatin was best at lowering LDL cholesterol, with an average reduction of 56 points. These results come from a network meta-analysis that allows indirect comparisons between drugs.
When it comes to kidney health, atorvastatin, rosuvastatin, and fenofibrate showed potential to improve the urine albumin-to-creatinine ratio, a marker of kidney damage. However, the exact size of this improvement was not reported.
For preventing heart-related events, atorvastatin and fenofibrate were most effective. Atorvastatin reduced the cardiovascular event rate by about 3.2 events per 100 patients, while fenofibrate reduced it by about 1.4 events per 100 patients.
The findings support a personalized approach to treatment, choosing drugs based on which risk factor is most concerning for each patient. However, the analysis did not report on side effects or study limitations.