No 'convincing evidence' that glitazones work better than older diabetes drugs

Apr 10, 2008

There is no convincing evidence that the newer class of diabetes drugs, known as glitazones, offer real advantages over other diabetes drugs, when used on their own, concludes the Drug and Therapeutics Bulletin (DTB).

The glitazones (pioglitazone and rosiglitazone), which are also used in combined double and triple therapy, now account for over half of the NHS spend on oral drugs for the regulation of blood sugar (glycaemic control).

New guidance on glitazones from the National institute for Health and Clinical Excellence (NICE) is expected next month.

An exhaustive trawl of the available evidence leads DTB to conclude that glitazones have a place in combined treatments with either metformin or a sulphonylurea people with type 2 diabetes who are unsuited to one or other of these older drugs.

But DTB makes it clear that there is “no convincing evidence” that when taken alone the glitazones produce greater health benefits than either of the other types of treatment.

“Evidence for their use in triple therapy is also weak, and they should be reserved for patients in whom insulin is contraindicated or is likely to be poorly tolerated,” says DTB.

The drugs can have significant side effects, although the regulators still feel that the benefits outweigh the risks.

Heart failure is more common when treatment is combined with insulin.

And in 2007 the European medicines regulator, the EMEA, warned that patients with angina who had had certain types of heart attack should not be given rosiglitazone, and the drug was not recommended for those with ischaemic heart, or peripheral arterial, diseases.

And the US drugs regulator, the FDA, has also advised that rosiglitazone may increase the risk of a heart attack.

Heart failure is more common when glitazone treatment is combined with insulin, and research indicates higher rates of oedema (swelling) in both sexes and bone fractures in women.

DTB concludes that pioglitazone is probably the safer option of the two glitazones, but should still not be used in anyone at high risk of heart failure.

Although pioglitazone is licensed for use with insulin treatment, DTB says that this combination carries the risk of weight gain, oedema and potentially heart failure.

Source: British Medical Journal

Explore further: Judge blocks Massachusetts ban on painkiller

add to favorites email to friend print save as pdf

Related Stories

Omega 3's -- more evidence for their benefit

Feb 09, 2011

Omega-3 fatty acids –fats commonly found in fish oil – were shown several years ago to prevent retinopathy, a major form of blindness, in a mouse model of the disease. A follow-up study, from the same research team ...

Benefit of glinides is not proven

Jun 18, 2009

The benefit of glinides in the treatment of type 2 diabetes is not scientifically proven. Nor do they perform better than other antidiabetics available in tablet form, such as metformin and sulfonylureas. As a result, there ...

Recommended for you

FDA approves new type 2 diabetes drug

14 hours ago

(HealthDay)—Millions of Americans with type 2 diabetes have a new treatment option with the U.S. Food and Drug Administration's approval Tuesday of a once-weekly injectable drug, Tanzeum.

AAFP provides tips to address patients' vaccine concerns

Apr 14, 2014

(HealthDay)—Physicians remain the biggest influence on whether patients get vaccinated, and must be prepared to address patients' reservations, according to an article published in the March/April issue ...

Tamiflu and Relenza: How effective are they?

Apr 11, 2014

Tamiflu (the antiviral drug oseltamivir) shortens symptoms of influenza by half a day, but there is no good evidence to support claims that it reduces admissions to hospital or complications of influenza. This is according ...

User comments : 0

More news stories

ESO image: A study in scarlet

This new image from ESO's La Silla Observatory in Chile reveals a cloud of hydrogen called Gum 41. In the middle of this little-known nebula, brilliant hot young stars are giving off energetic radiation that ...

First direct observations of excitons in motion achieved

A quasiparticle called an exciton—responsible for the transfer of energy within devices such as solar cells, LEDs, and semiconductor circuits—has been understood theoretically for decades. But exciton movement within ...

Patent talk: Google sharpens contact lens vision

(Phys.org) —A report from Patent Bolt brings us one step closer to what Google may have in mind in developing smart contact lenses. According to the discussion Google is interested in the concept of contact ...

Warm US West, cold East: A 4,000-year pattern

Last winter's curvy jet stream pattern brought mild temperatures to western North America and harsh cold to the East. A University of Utah-led study shows that pattern became more pronounced 4,000 years ago, ...