Doxazosin appears to work synergistically with acarbose to improve metabolic control in patients with impaired glucose tolerance. Dr. Guiseppe Derosa of the University of Pavia and colleagues sought to determine whether doxazosin had a synergistic effect when combined with antihyperglycemic treatment with the alpha-glucosidase inhibitor acarbose.
To investigate, the researchers studied 107 patients with impaired glucose tolerance. For 3 months, they received acarbose 150 mg per day and were randomized to also receive doxazosin 4 mg per day or placebo.
They were then titrated to receive up to 300 mg of acarbose daily and to continue with their assigned doxazosin or placebo for a further 3 months.
At 6 months, in both groups, there were significant reductions in body mass index (3.6%), HbA1c (9.9%), fasting plasma glucose (8.4%) and post prandial plasma glucose (16.3%). In addition, all tested patients showed a return to normal glucose tolerance.
There also was a significant improvement in fasting plasma insulin levels in the doxazosin group compared to the placebo group. This was also the case for the significant drop seen in the homeostasis model assessment index.
In addition, there were significant favorable changes in lipid parameters in the doxazosin group and reductions in blood pressure that were not seen in the placebo group.
Compared to use of acarbose alone, the researchers conclude that the benefits of the combination go beyond improvements in blood pressure and appear to enhance both glycemic and lipid control.
Clin Drug Invest 2006;26:529-539.
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