Issue 211 Item5 The RESULT Trial

Reduction in the use of health care services with sulfonylurea and rosiglitazone. This study compared the healthcare use of patients randomized to progressive SU titration or combined SU and RSG in the RESULT trial, a 2-year randomized, double-blind, placebo controlled trial in elderly patients with type 2 diabetes.
Elderly type 2 diabetes patients initially on submaximal dose of glipizide were randomized to receive rosiglitazone combined with glipizde (n=115) or uptitrated glipizide monotherapy (n=110).

Management was individualized to glycemic targets. Self-reported healthcare use (hospitalizations, emergency room (ER) visits, physician visits, bed days, restricted activity days) was prospectively collected for the trial duration. Mean age and duration of diabetes of the 2 groups were similar. At study end, glycemic parameters were better controlled in rosiglitazone and glipizde. In comparison with progressive SU titration, rosiglitazone and glipizde had significantly fewer ER visits (p<.01), hospitalizations (p<.05), and bed days (p<.01). Although numerically greater during progressive SU titration, there were no significant differences in unscheduled office visits and restricted activity days.

Treatment costs were significantly lower with rosiglitazone plus glipizide ($428 per patient per month PPPM) than with progressive SU titration ($567 PPPM) (p<.05).

Early addition of rosiglitazone to sulfonylurea was associated with a decreased use of medical resources, in particular hospitalizations and ER visits, although exact causality could not be established. This therapeutic approach has the potential to improve patient care and reduce overall treatment costs. Abstract 64th Scientific Sessions

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