Once- and Twice-Daily Dosing With Rosiglitazone Improves Glycemic Control in Patients With Type 2 Diabetes
- Lawrence S. Phillips, MD,
- George Grunberger, MD,
- Elizabeth Miller, RN, BA,
- Rita Patwardhan, PHD,
- Elizabeth B. Rappaport, MD,
- Alan Salzman, MD, PHD and
- the Rosiglitazone Clinical Trials Study Group
- From the Division of Endocrinology (L.S.P.), Emory University School of Medicine, Atlanta, Georgia; the Center for Molecular Medicine and Genetics and the Department of Internal Medicine (G.G.), Wayne State University, Detroit, Michigan; and Smithkline Beecham Pharmaceuticals (E.M., R.P., E.B.R., A.S.), Collegeville, Pennsylvania.
- Address correspondence and reprint requests to Lawrence S. Phillips, MD, Division of Endocrinology, Emory University School of Medicine, 1639 Pierce Dr., 1301 Woodruff Memorial Bldg., Atlanta, GA 30322. E-mail: medlsp{at}emory.edu .
Abstract
OBJECTIVE— To determine the efficacy of rosiglitazone compared with placebo in reducing hyperglycemia.
RESEARCH DESIGN AND METHODS— After a 4-week placebo run-in period, 959 patients were randomized to placebo or rosiglitazone (total daily dose 4 or 8 mg) for 26 weeks. The primary measure of efficacy was change in the HbAlc concentration.
RESULTS— Rosiglitazone produced dosage-dependent reductions in HbAlc of 0.8, 0.9, 1.1, and 1.5% in the 4 mg o.d., 2 mg b.i.d., 8 mg o.d., and 4 mg b.i.d. groups, respectively, compared with placebo. Clinically significant decreases from baseline in HbAlc were observed in drug-naive patients at all rosiglitazone doses and in patients previously treated with oral monotherapy at rosiglitazone 8 mg o.d. and 4 mg b.i.d. Clinically significant decreases from baseline in HbAlc were also observed with rosiglitazone 4 mg b.i.d. in patients previously treated with combination oral therapy. Approximately 33% of drug-naive patients treated with rosiglitazone achieved HbAlc ≤7% at study end. The proportions of patients with at least one adverse event were comparable among the rosiglitazone and placebo groups. There was no evidence of hepatotoxicity in any treatment group. There were statistically significant increases in weight and serum lipids in all rosiglitazone treatment groups compared with placebo. For LDL and HDL cholesterol, the observed increase appeared to be dose related.
CONCLUSIONS— Rosiglitazone at total daily doses of 4 and 8 mg significantly improved glycemic control in patients with type 2 diabetes and was well tolerated.
Footnotes
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A.S. holds stock in SmithKline Beecham Pharmaceuticals, and E.B.R. holds stock in SmithKline Beecham Pharmaceuticals and Johnson & Johnson Corporation.
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Abbreviations: ALT, alanine aminotransferase; HOMA, homeostasis model assessment; PPAR-γ, peroxisome proliferator-activated receptor-γ.
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A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
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- Accepted October 12, 2000.
- Received June 8, 2000.
- by the American Diabetes Association, Inc.
