Issue 126 Item 14 Glipizide GITS Has Advantages Over Other Second-Generation Sul

Once daily dosing improves outcomes with better compliance. In a ‘real-world’ comparison, type 2 diabetics treated with glipizide gastrointestinal therapeutic system (GITS) demonstrated better adherence than patients using glipizide immediate release and glibenclamide, researchers report.

"Our study found that patients initiated on glipizide GITS were less likely to experience treatment change and had longer duration of therapy compared to glipizide immediate release and glibenclamide," Dr. Carolyn R. Harley from Ingenix Inc., Eden Prairie, Minnesota, told Reuters Health.

"These results may be attributed to GITS’ extended-release formulation, which may lead to better glucose control and fewer side effects, particularly hypoglycemia," Dr. Harley said.

In a retrospective claims analysis, Dr. Harley and colleagues collected data on 24,331 patients with type 2 diabetes. Of these subjects 35% filled a first prescription for glipizide GITS, 15% for glipizide immediate release and 50% for glibenclamide. At the end of the study (1620 days) 79% of the subjects had discontinued treatment.

Cox proportional hazard analysis showed that, compared with patients on glipizide GITS, those taking glipizide immediate release were 1.3 times more likely to experience treatment change during the first 90 days of therapy, and patients taking glibenclamide were 1.2 times more likely.

At 1620 days, the results of the analysis were similar to the 90-day results, Dr. Harley’s team adds.

In addition, patients taking glipizide immediate release and glibenclamide were significantly less likely to adhere to therapy (p < 0.001) than those on glipizide GITS, according to the report in the September issue of Clinical Drug Investigations.

Dr. Harley and colleagues conclude that "while this study does not establish a direct link between non-adherence and the need for therapy modification, it does identify an association between glipizide GITS and higher levels of adherence and longer time to therapy modification."

They add that "the results suggest that there are ‘real-life’ advantages with the uses of glipizide GITS, a once-daily time-release sulphonylurea, over glipizide immediate release and glibenclamide." Clin Drug Invest 2002;22:575-584.