Comparison of glycaemic control over 1 year with pioglitazone or gliclazide in patients with Type 2 diabetes

Perriello, G.; Pampanelli, S.; Pietro, Caterina Di; Brunetti, P

doi:10.1111/j.1464-5491.2006.01801.x

Cited by 33 publications

(28 citation statements)

References 25 publications

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“…Gliclazide was compared to other SUs/meglitinides in eight studies [8], [14], [20], [21], [27], [29], [33], [36], to metformin in four studies [22], [23], [25], [28], to pioglitazone in four studies [28], [30]–[32], to DPP-4 inhibitors in two studies [34], [35] and to an α-glucosidase inhibitor in two studies [24], [26]. One study compared gliclazide to both metformin and pioglitazone [28].…”

Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Gliclazide as Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

et al. 2014

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Objective and DesignGliclazide has been associated with a low risk of hypoglycemic episodes and beneficial long-term cardiovascular safety in observational cohorts. The aim of this study was to assess in a systematic review and meta-analysis of randomized controlled trials the safety and efficacy of gliclazide compared to other oral glucose-lowering agents (PROSPERO2013:CRD42013004156)Data SourcesMedline, EMBASE, Clinicaltrials.gov, Trialregister.nl, Clinicaltrialsregister.eu and the Cochrane database.SelectionIncluded were randomized studies of at least 12 weeks duration with the following outcomes: HbA1c change, incidence of severe hypoglycemia, weight change, cardiovascular events and/or mortality when comparing gliclazide with other oral blood glucose lowering drugs. Bias was assessed with the Cochrane risk of bias tool. The inverse variance random effects model was used.ResultsNineteen trials were included; 3,083 patients treated with gliclazide and 3,155 patients treated with other oral blood glucose lowering drugs. There was a considerable amount of heterogeneity between and bias in studies. Compared to other glucose lowering agents except metformin, gliclazide was slightly more effective (−0.13% (95%CI: −0.25, −0.02, I2 55%)). One out of 2,387 gliclazide users experienced a severe hypoglycemic event, whilst also using insulin. There were 25 confirmed non-severe hypoglycemic events (2.2%) in 1,152 gliclazide users and 22 events (1.8%) in 1,163 patients in the comparator group (risk ratio 1.09 (95% CI: 0.20, 5.78, I2 77%)). Few studies reported differences in weight and none were designed to evaluate cardiovascular outcomes.ConclusionsThe methodological quality of randomized trials comparing gliclazide to other oral glucose lowering agents was poor and effect estimates on weight were limited by publication bias. The number of severe hypoglycemic episodes was extremely low, and gliclazide appears at least equally effective compared to other glucose lowering agents. None of the trials were designed for evaluating cardiovascular outcomes, which warrants attention in future randomized trials.

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Section: Resultsmentioning

confidence: 99%

Safety and Efficacy of Gliclazide as Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

et al. 2014

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“…27 Furthermore, pioglitazone has been shown to induce sustainable improvements in insulin processing and ␤-cell function, whereas SUs do not. 29,30 In vitro studies have also shown that pioglitazone can prevent ␤-cell apoptosis. 31 The ␤-cell sparing effect of pioglitazone was further indicated in a recent, large, prospective, randomized trial where treatment with pioglitazone reduced the progression to permanent insulin use by 50%.…”

Section: Discussionmentioning

confidence: 97%

Effects of Pioglitazone in Combination with Metformin or a Sulfonylurea Compared to a Fixed-Dose Combination of Metformin and Glibenclamide in Patients with Type 2 Diabetes

Comaschi¹,

Demicheli

Pietro

et al. 2007

Diabetes Technology & Therapeutics

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“…Two subsequent randomised controlled trials have compared pioglitazone monotherapy and pioglitazone plus metformin 11 , 12. In one, a double-blind study involving 283 patients with type 2 diabetes given either pioglitazone 30–45mg daily or gliclazide 80–320mg daily for 1 year, HbA 1c levels fell by 0.79% in both groups 11.…”

Section: Glycaemic Controlmentioning

confidence: 99%

“…In one, a double-blind study involving 283 patients with type 2 diabetes given either pioglitazone 30–45mg daily or gliclazide 80–320mg daily for 1 year, HbA 1c levels fell by 0.79% in both groups 11. In the other, non-blinded, study, which lasted 28 weeks and involved 203 adults with poorly controlled type 2 diabetes (HbA 1c 7.5–10%) on metformin alone, the addition of pioglitazone or glimepiride produced similar overall falls in HbA 1c (by 1.23% and 1.30%, respectively, p = 0.4825) 12…”

Section: Glycaemic Controlmentioning

confidence: 99%

Glitazones in type 2 diabetes: an update

2008

DTB

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The glitazones and their combination products are licensed for type 2 diabetes mellitus and now account for over 50% of NHS expenditure on oral hypoglycaemic drugs. In 2001, for pioglitazone and rosiglitazone (the two glitazones licensed in the UK), we concluded that evidence (from short-term studies) supported their use in combination with metformin or a sulphonylurea in patients unsuited to one or other of these drugs, but not more practical glitazone use, such as monotherapy or as part of triple therapy. We also said that their long-term effects were not yet clear. Since then, both drugs have also been licensed for monotherapy, as part of triple therapy that includes metformin and a sulphonylurea and, for pioglitazone, use with insulin. Here we reassess glitazones in light of published efficacy data and safety concerns raised in recent years.

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Comparison of glycaemic control over 1 year with pioglitazone or gliclazide in patients with Type 2 diabetes

Cited by 33 publications

References 25 publications

Safety and Efficacy of Gliclazide as Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

Safety and Efficacy of Gliclazide as Treatment for Type 2 Diabetes: A Systematic Review and Meta-Analysis of Randomized Trials

Effects of Pioglitazone in Combination with Metformin or a Sulfonylurea Compared to a Fixed-Dose Combination of Metformin and Glibenclamide in Patients with Type 2 Diabetes

Glitazones in type 2 diabetes: an update

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