Management of cardiovascular risk factors with pioglitazone combination therapies in type 2 diabetes: an observational cohort study

Cardiovascular Diabetology

Original Investigation

Ángel Rodríguez¹  Jesús Reviriego¹  Francisco J del Cañizo²  Vangelis Drossinos³  Vasilios Karamanos⁴  Nikolaos Vlachogiannis⁵ 

[1] Clinical Research Department, Lilly, S.A., Avda, de la Industria, 30, 28108, Alcobendas, Madrid, Spain;Department of Endocrinology and Nutrition, University Hospital Infanta Leonor, School of Medicine, Universidad Complutense, Gran Vía del Este, 80, 28031, Madrid, Spain;Department of Medical Research, Pharmaserve-Lilly S.A.C.I., National Route Athens-Lamia, 14564, Kifissia, Greece;Diabetes Center, 2nd Department of Internal Medicine and Research Laboratory, National University of Athens, Hippokration General Hospital, Vas Sofias 114, 11527, Ambelokipoi, Athens, Greece;Health Center of Lavrion, General Hospital of Athens "G. Gennimatas", Mesogeion 154, 11527, Athens, Greece;

关键词: Fast Plasma Glucose;    Pioglitazone;    Gliclazide;    International Diabetes Federation;    Glimepiride;   

DOI  :  10.1186/1475-2840-10-18

 received in 2011-01-04, accepted in 2011-02-11,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundType 2 diabetes (T2D) is strongly associated with cardiovascular risk and requires medications that improve glycemic control and other cardiovascular risk factors. The authors aimed to assess the relative effectiveness of pioglitazone (Pio), metformin (Met) and any sulfonylurea (SU) combinations in non-insulin-treated T2D patients who were failing previous hypoglycemic therapy.MethodsOver a 1-year period, two multicenter, open-labeled, controlled, 1-year, prospective, observational studies evaluated patients with T2D (n = 4585) from routine clinical practice in Spain and Greece with the same protocol. Patients were eligible if they had been prescribed Pio + SU, Pio + Met or SU + Met serving as a control cohort, once they had failed with previous therapy. Anthropometric measurements, lipid and glycemic profiles, blood pressure, and the proportions of patients at microvascular and macrovascular risk were assessed.ResultsAll study treatment combinations rendered progressive 6-month and 12-month lipid, glycemic, and blood pressure improvements. Pio combinations, especially Pio + Met, were associated with increases in HDL-cholesterol and decreases in triglycerides and in the atherogenic index of plasma. The proportion of patients at high risk decreased after 12 months in all study cohorts. Minor weight changes (gain or loss) and no treatment-related fractures occurred during the study. The safety profile was good and proved similar among treatments, except for more hypoglycemic episodes in patients receiving SU and for the occurrence of edema in patients using Pio combinations. Serious cardiovascular events were rarely reported.ConclusionsIn patients with T2D failing prior hypoglycemic therapies, Pio combinations with SU or Met (especially Pio + Met) improved blood lipid and glycemic profiles, decreasing the proportion of patients with a high microvascular or macrovascular risk. The combination of Pio with SU or Met may therefore be recommended for T2D second-line therapy in the routine clinical practice, particularly in patients with dyslipidemia.

【 授权许可】

CC BY   
© Rodríguez et al; licensee BioMed Central Ltd. 2011