Rosiglitazone, Pioglitazone Equally Effective in Type 2 Diabetes Therapy

Rosiglitazone and pioglitazone, as part of triple oral therapy, are equally effective in bringing hemoglobin A1C levels down to recommended levels in type 2 diabetic patients.

"Many patients failing maximal doses of metformin plus a sulfonylurea agent will respond satisfactorily to adding a maximal dose of a glitazone," Dr. Mayer B. Davidson told Reuters Health. "In our hands, two-thirds will do so initially. In these patients, it is not necessary to use insulin at this time, although most will eventually require it."

Dr. Davidson and two colleagues from Charles R. Drew University in Los Angeles studied 104 adult type 2 diabetic patients whose hemoglobin A1C did not meet the American Diabetes Association goal of less than 7.0% despite maximum tolerated doses of metformin and a sulfonylurea.

Fifty-six patients added pioglitazone and 48 added rosiglitazone to their existing anti-diabetes regimen.

Four months after adding pioglitazone, A1C levels had fallen from 9.5% at baseline to a healthier 7.4%, the team reports. Thirty-five of 56 patients who added pioglitazone (62%) achieved A1C levels below 7.5% at 4 months and 22 of these responders (63%) were still responding at 1 year.

The results were similar for patients who added rosiglitazone. Four months after adding this glitazone, A1C levels had fallen from 9.4% at baseline to 7.5%. Thirty-one of 48 patients (65%) achieved A1C levels below 7.5% at 4 months and 19 responders (61%) were still responding at 1 year.

"There is no difference between rosiglitazone and pioglitazone," Dr. Davidson told Reuters Health, in terms of the glycemic effect when added to maximum tolerated doses of metformin and a sulfonylurea.

"This is not surprising," Dr. Davison added, "because other studies have shown no difference when they are used as monotherapy or as the second drug."

Diabetes Care 2006;29:1395-1396.

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