Two RCTs that used atorvastatin (3,665 patients) and one RCT that assessed fenofibrate (9,795 patients) were included in the main synthesis. Follow-up was approximately four to five years. A second RCT that assessed atorvastatin (2,838 patients) was discussed but this trial was terminated early and so was excluded from the main synthesis.
Two statin RCTs were reported to have credible validation and classification of the endpoints and a third eligible statin RCT had unclear validity.
The two RCTs that assessed atorvastatin showed no benefit from statins in patients with diabetes. The RCT that assessed atorvastatin in patients with diabetes and end stage renal disease showed a statistically significantly greater risk of fatal stroke with atorvastatin compared to placebo (RR 2.03, 95% CI 1.05 to 3.93).
The eligible trial that assessed fibrate also showed no benefit in terms of cardiovascular complications and overall mortality compared to placebo. The terminated trial was discussed in the review.