PIOfix-Study: Effects of Pioglitazone/Metformin Fixed Combination in Comparison with a Combination of Metformin with Glimepiride on Diabetic Dyslipidemia

Pfützner, Andreas; Schöndorf, Thomas; Tschöpe, D; Lobmann, Ralf; Merke, J.; Müller, J; Lehmann, Ute; Fuchs, Winfried; Forst, Thomas

doi:10.1089/dia.2010.0233

Cited by 17 publications

(12 citation statements)

References 26 publications

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“…[2122] In patients with type 2 diabetes, there is a strong association between high triglyceride and low HDL cholesterol levels and cardiovascular morbidity and mortality. [22] There have been concerns over liver toxicity with TZDs. [23] In our study, both sitagliptin and pioglitazone caused slight, nonsignificant elevation in mean levels of hepatic enzymes.…”

Section: Discussionmentioning

confidence: 99%

Effect of addition of either sitagliptin or pioglitazone in patients with uncontrolled type 2 diabetes mellitus on metformin: A randomized controlled trial

Chawla

Kaushik

Singh

et al. 2013

Journal of Pharmacology and Pharmacotherapeutics

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Objective:To compare and study the dipeptidy1 peptidase-4 (DPP-4) inhibitors in combination with metformin against established combination therapies.Materials and Methods:This 16-week study was designed to compare sitagliptin versus pioglitazone as add-on therapy in patients of type 2 diabetes mellitus inadequately controlled with metformin alone. Fifty-two patients were randomized into two groups to receive either sitagliptin 100 mg (group 1) or pioglitazone 30 mg (group 2) in addition to metformin. The primary efficacy end point was change in HbA1c. Secondary end points included change in fasting plasma glucose (FPG), body weight and lipid profile. Treatment satisfaction was assessed using the Diabetes Treatment Satisfaction Questionnaire. Both the groups had a significant decrease in HbA1c.Results:There was no significant difference between mean reductions in FPG in both the groups. There was a significant decrease in the mean body weight and body mass index in group 1 in contrast to the significant increase in the same in group 2. Both the treatment groups reported a significant decrease in High-density lipoprotein (HDL-C) and Triglyceride.Conclusion:Sitagliptin was well tolerated without any incidence of hypoglycemia. It was concluded that sitagliptin as an add-on to metformin is as effective and well tolerated as pioglitazone.

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Section: Discussionmentioning

confidence: 99%

Effect of addition of either sitagliptin or pioglitazone in patients with uncontrolled type 2 diabetes mellitus on metformin: A randomized controlled trial

Chawla

Kaushik

Singh

et al. 2013

Journal of Pharmacology and Pharmacotherapeutics

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“…Although similar improvements in HbA1c were seen with both treatments within 6 months, the pioglitazone + metformin combination had a significantly better effect on triglycerides and HDL cholesterol, and a pronounced hs-CRP improvement was seen in this arm (-0.9 ± 1.9 mg/dl), whereas no effect on hs-CRP could be observed with the glimepiride + metformin combination (0.0 ± 1.8 mg/liter, p < 0.001). 56 Insulin resistance may also be present in normoglycemic individuals, and some of these patients can be diagnosed as having (cardio)metabolic syndrome. Research in these study populations confirmed the efficacy of pioglitazone treatment for reducing chronic systemic inflammation and hs-CRP levels independently from glucose-lowering mechanisms.…”

Section: Effects Of Pioglitazone Treatment On Hs-crp Reductionmentioning

confidence: 99%

High-Sensitivity C-Reactive Protein Predicts Cardiovascular Risk in Diabetic and Nondiabetic Patients: Effects of Insulin-Sensitizing Treatment with Pioglitazone

Pfützner

Schöndorf

Hanefeld

et al. 2010

J Diabetes Sci Technol

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Abbreviations: (BMI) body mass index, (CVD) cardiovascular disease, (HbA1c) hemoglobin A1c, (HOMA) homeostasis model assessment, (hs-CRP) high-sensitivity C-reactive protein, (LDL) low-density lipoprotein, (PPARγ) peroxisome proliferator-activated receptor-γ Keywords: atherosclerosis, diabetes, hs-CRP, inflammation, insulin resistance, pioglitazone AbstractSystemic inflammatory activity has turned out to play a key pathogenic role in vascular atherosclerosis, insulin resistance, and type 2 diabetes mellitus. Inflammatory biomarkers may therefore be a valuable tool for risk evaluation. Among them, the best evidence to date supports the use of high-sensitivity C-reactive protein (hs-CRP) to monitor insulin resistance and cardiovascular risk in diabetic and nondiabetic individuals. Data suggest that hs-CRP may also participate directly in the process of atherogenesis. A growing number of clinical trials tested the hypothesis that antidiabetic drugs specifically targeting insulin resistance could benefit individuals by reducing inflammation, atherogenesis, and thus cardiovascular risk. One such class are the thiazolidinediones (pioglitazone and rosiglitazone). These agents act as selective ligands of the nuclear transcription factor peroxisome proliferator-activated receptor-γ (PPARγ). This article reviewed published data on hs-CRP changes with the thiazolidinedione agent pioglitazone. Here we found pronounced insulin-sensitizing and anti-inflammatory properties in different clinical settings, including diabetic and nondiabetic individuals. Coadministration of pioglitazone to antilipidemic statin therapy resulted in additional effects on low-grade inflammation, and hs-CRP reduction has been demonstrated to occur independently of glucose lowering. The anti-inflammatory effect appeared to be a rapid physiologic reaction on PPARγ activation and could be observed within a short-term interval after starting pioglitazone therapy. In summary, clinical study results underline the benefit of an early insulin resistance treatment to oppose systemic vascular inflammation and cardiometabolic syndrome in patients with elevated levels of high-sensitivity C-reactive protein.

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“…It has become tremendously popular, and the choice of drug for management of T2DM, owing to its hypoglycemic as well as hypolipidemic effects. The increase in triglycerides in T2DM is accompanied by proatherosclerotic functional changes in HDL and LDL particles [6] and metformin affects a reduction in LDL cholesterol as well as triglyceride levels in blood and hence could be protective against the effects of dyslipidemia [7]. It is the only antidiabetic drug that has been conclusively shown to prevent the cardiovascular complications of diabetes and does not cause weight gain.…”

Section: Introductionmentioning

confidence: 99%

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

et al. 2012

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The nature of the dyslipidemia associated with diabetes mellitus is complex and is the major risk factor for atherosclerosis and coronary artery disease. Aim of this study was to assess the effect of glycemic control, achieved by metformin, glibenclamide and insulin, on lipid profile in type 2 diabetic patients. One hundred and sixty-five type 2 diabetes mellitus patients were classified into good glycemic control (Group I) and poor glycemic control (Group II) on the basis of their blood HbA1c values. The Group II was characterized with high serum triglyceride (190.46 ± 15.20 mg/dl), total cholesterol (175.3 ± 6.31 mg/dl) as well as high LDL-cholesterol (109.0 ± 5.88 mg/dl). Significant correlations were evident between HbA1c and dyslipidemia, particularly serum TG (r = 0.28, P < 0.05), and between HbA1c and total cholesterol (r = 0.310, P < 0.05). Better glycemic control and improved dyslipidemia were observed in patients on combination therapy of metformin plus glibenclamide.

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PIOfix-Study: Effects of Pioglitazone/Metformin Fixed Combination in Comparison with a Combination of Metformin with Glimepiride on Diabetic Dyslipidemia

Cited by 17 publications

References 26 publications

Effect of addition of either sitagliptin or pioglitazone in patients with uncontrolled type 2 diabetes mellitus on metformin: A randomized controlled trial

Effect of addition of either sitagliptin or pioglitazone in patients with uncontrolled type 2 diabetes mellitus on metformin: A randomized controlled trial

High-Sensitivity C-Reactive Protein Predicts Cardiovascular Risk in Diabetic and Nondiabetic Patients: Effects of Insulin-Sensitizing Treatment with Pioglitazone

Dyslipidemia Associated with Poor Glycemic Control in Type 2 Diabetes Mellitus and the Protective Effect of Metformin Supplementation

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