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Rosiglitazone Shows Modest Benefit for Glycemic Control

Drug may have worse side effects than older, cheaper drugs

MONDAY, Dec. 4 (HealthDay News) -- Rosiglitazone modestly improves glycemic control but may increase the risk of cardiovascular events, edema and weight gain compared with older and cheaper drugs, according to study findings published in the Dec. 7 issue of the New England Journal of Medicine.

Steven E. Kahn, M.B., Ch.B., from the Veterans Affairs Puget Sound Health Care System in Seattle, and colleagues randomized 4,360 patients with recently diagnosed type 2 diabetes to the thiazolidinedione rosiglitazone or to one of two older drugs, metformin or glyburide, for a median of four years. The researchers assessed time to treatment failure, defined as fasting plasma glucose greater than 180 mg/dL.

The risk of failure at five years with rosiglitazone treatment was significantly reduced by 32 percent compared with metformin and by 63 percent compared with glyburide. Compared with rosiglitazone, the risk of cardiovascular events was significantly reduced with glyburide, while the risks were similar with metformin. The study found significantly more weight gain and edema in patients taking rosiglitazone, but fewer gastrointestinal events and less hypoglycemia compared with metformin and glyburide, respectively.

"Given the modest glycemic benefit of rosiglitazone…and higher cost…metformin remains the logical choice when initiating pharmacotherapy for type 2 diabetes," states the author of an accompanying editorial.

The study was supported by grants from GlaxoSmithKline.

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