The Use of Statins for Primary Prevention in Asian patients with Young-onset Diabetes and CKD

Despite the proven effectiveness of lipid management, there are major treatment gaps, especially in Asian patients with young-onset diabetes and chronic kidney disease (CKD).

Recent international guidelines recommended the adoption of absolute risk estimation of atherosclerosis and cardiovascular disease (CVD) to guide treatment intensity. These recommendations replaced the previous strategy of using low-density lipoprotein cholesterol (LDL-C) targets to guide initiation and intensification of lipid-lowering, albeit still widely practiced in Asia. Given the propensity of Asian patients with diabetes to develop CKD and the amplifying effect of CKD on atherosclerotic cardiovascular disease (ASCVD), the use of statins in Asian patients is particularly important. Due to inter-ethnic differences in drug metabolism, rosuvastatin, which is largely cleared by the kidney, should be prescribed in low dosages (5-10 mg daily) in Asian populations.

However, there is a need for Asian countries to review and align their lipid-lowering treatment guidelines to reduce the substantial burden of diabetes and CKD in the Asian region.