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Message: Just back from IR,...

Toinv - I am no scientist but Rosuvastatin is water soluable and Atorvastatin is lipid soluable (lipophilic). They do have different effects on insulin and diabetes. Below is something I found that maybe our scientists could expand on further as to possible differing interactions.

https://www.gpnotebook.co.uk/simplepage.cfm?ID=x20120104193906598025

"Insulin resistance:

  • lipophilic statins may have adverse metabolic consequences that include impaired insulin secretion and promotion of insulin resistance (1)
  • hydrophilic statins
    • pravastatin improves insulin sensitivity in some patients (1)
    • rosuvastatin
      • does not change insulin sensitivity in patients with metabolic syndrome or familial combined hyperlipidemia. However, it increases the incidence of type 2 diabetes (4). Interestingly, rosuvastatin increases the rate of onset of new diabetes in a dose-dependent manner (hazard ratio = 1.10, 1.14, and 1.26, respectively)"

To your functional HDL point, I believe you are referring to Merck's Anaceptrapib. At the same time the ASSURE results were announced, Merck made a big splash with results of a huge increase in HDL. Anaceptrapib is a CETP inhibitor and RVX had already disclaimed these drugs as raising non-functional HDL because when used up, these drugs weren't allowing the HDL to be removed from the body. The HDL volume went way up without improved effectiveness. I believe Merck continued testing and concluded in about 2017 that they were not getting any 3 point MACE improvement from the higher HDL levels but continued trying to develop the drug for LDL lowering. This is from my memory so hopefully not too far off and I am not sure if they are still pursuing this or not.

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