Comparative risk of new-onset diabetes between pravastatin and commonly used statins: A systematic review and meta-analysis

Introduction Statin therapy has been associated with an increased risk of new-onset diabetes mellitus (NODM). This systematic review and meta-analysis compared the risk of NODM between pravastatin and two commonly used statins. Methods We searched PubMed/MEDLINE, EMBASE, CENTRAL, and ClinicalTrials.gov from inception to May 23, 2024. Original studies comparing pravastatin with atorvastatin and/or rosuvastatin were included. Risk of bias was assessed using established, study-design–specific tools. Data were pooled using a random-effects model implemented in RevMan version 5.4.1. Statistical heterogeneity was assessed using the I 2 statistic. Results Eighteen studies were included, of which ten contributed to the meta-analysis. The comparison of pravastatin versus atorvastatin (10 studies; N = 95,276 vs 490,905) yielded a pooled risk ratio (RR) of 1.01 (95% CI: 0.77–1.32; I 2 = 98%). Pravastatin versus rosuvastatin (9 studies; N = 92,853 vs 114,718) yielded a pooled RR of 1.12 (95% CI: 0.85–1.47; I 2 = 96%). Conclusion Pravastatin did not demonstrate a lower risk of NODM when compared with atorvastatin or rosuvastatin; nevertheless, further research remains warranted.