Efficacy and Safety of Pioglitazone versus Glimepiride after Metformin and Alogliptin Combination Therapy: A Randomized, Open-Label, Multicenter, Parallel-Controlled Study
Diabetes & Metabolism Journal
; : 67-77, 2020.
Article
in English
| WPRIM (Western Pacific)
| ID: wpr-811147
Responsible library:
WPRO
ABSTRACT
BACKGROUND:
There is limited information regarding the optimal third-line therapy for managing type 2 diabetes mellitus (T2DM) that is inadequately controlled using dual combination therapy. This study assessed the efficacy and safety of pioglitazone or glimepiride when added to metformin plus alogliptin treatment for T2DM.METHODS:
This multicenter, randomized, active-controlled trial (ClinicalTrials.gov NCT02426294) recruited 135 Korean patients with T2DM that was inadequately controlled using metformin plus alogliptin. The patients were then randomized to also receive pioglitazone (15 mg/day) or glimepiride (2 mg/day) for a 26-week period, with dose titration was permitted based on the investigator's judgement.RESULTS:
Glycosylated hemoglobin levels exhibited similar significant decreases in both groups during the treatment period (pioglitazone −0.81%, P<0.001; glimepiride −1.05%, P<0.001). However, the pioglitazone-treated group exhibited significantly higher high density lipoprotein cholesterol levels (P<0.001) and significantly lower homeostatic model assessment of insulin resistance values (P<0.001). Relative to pioglitazone, adding glimepiride to metformin plus alogliptin markedly increased the risk of hypoglycemia (pioglitazone 1/69 cases [1.45%], glimepiride 14/66 cases [21.21%]; P<0.001).CONCLUSION:
Among patients with T2DM inadequately controlled using metformin plus alogliptin, the addition of pioglitazone provided comparable glycemic control and various benefits (improvements in lipid profiles, insulin resistance, and hypoglycemia risk) relative to the addition of glimepiride.
Full text:
Available
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
WPRIM (Western Pacific)
Main subject:
Sulfonylurea Compounds
/
Glycated Hemoglobin
/
Insulin Resistance
/
Treatment Failure
/
Thiazolidinediones
/
Diabetes Mellitus, Type 2
/
Drug Therapy, Combination
/
Dipeptidyl-Peptidase IV Inhibitors
/
Hypoglycemia
/
Cholesterol, HDL
Type of study:
Controlled clinical trial
Limits:
Humans
Language:
English
Journal:
Diabetes & Metabolism Journal
Year:
2020
Document type:
Article