Older Diabetes Drugs As Good and Cheaper Than New Ones

Second-generation sulfonylureas and metformin equal to or better than more-recent drugs

TUESDAY, July 17 (HealthDay News) -- The first comprehensive review of literature on the relative benefits of oral diabetes drugs, published online July 17 in the Annals of Internal Medicine, concludes that older drugs are just as effective and sometimes better than new drugs for a lower price. The research was conducted by the Johns Hopkins Evidence-based Practice Center in Rockville, Md., under contract from the Agency for Healthcare Research and Quality.

A review of research comparing the efficacy of diabetes medications for short-term outcomes found that the effects of metformin were similar or superior to newer drugs such as thiazolidinediones and meglitinides. Second-generation sulfonylureas produced similar results compared to thiazolidinediones and meglitinides.

The most serious adverse effects were associated with thiazolidinediones (congestive heart failure) and second-generation sulfonylureas (serious hypoglycemia). Lactic acidosis rates were similar across the different medications, and the risk of serious adverse events was lower with metformin than second-generation sulfonylureas and thiazolidinediones.

Combining medications also combined the risk of adverse effects, and when used in combination, lower doses of individual drugs reduced the risk of adverse effects.

"Physicians and patients can feel comfortable using older medications such as metformin and second-generation sulfonylureas, as monotherapy or in combination, before newer diabetes medications such as thiazolidinediones or meglitinides, especially when cost is a factor," the report concludes.

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