Authors: Norris, Susan L.; Carson, Susan; Roberts, Carol

Source: Current Diabetes Reviews, Volume 3, Number 2, May 2007 , pp. 127-140(14)

Publisher: Bentham Science Publishers

Abstract:

Objective - To assess the comparative efficacy and safety of pioglitazone and rosiglitazone.

Research design and methods - Multiple electronic databases were searched for randomized, controlled trials (RCTs) of efficacy or effectiveness and for studies of any design which reported adverse events. Pooled estimates were calculated using a random effects model.

Results - Eighty-seven RCTs fulfilled our inclusion criteria for efficacy or effectiveness and 42 studies examined safety or tolerability. Two head-to-head RCTs of type 2 diabetes demonstrated significant improvements in A1c in both groups at follow-up with no significant difference between groups; a third study found no significant change in A1c in either group. The pooled estimate of effect on A1c for pioglitazone compared to placebo was -0.99% (95% confidence interval [CI], -1.18, -0.81) and for rosiglitazone was -0.92% (95% CI, - 1.2, -0.64). Indirect comparison revealed no significant difference in A1c (between-drug difference -0.07% [95% CI, -0.41, 0.27]). Rosiglitazone increased total cholesterol compared to pioglitazone (net between-drug effect 13.91 mg/dl [95% CI, 1.20 to 26.62]). Both drugs increased weight by 2 to 3 kg and rates of adverse events were similar for the two drugs. Data were insufficient to assess comparative effects on health outcomes such as cardiovascular events.

Conclusions - Based largely on indirect evidence, the two thiazolidinediones appear to have similar effects on glycemic control and similar side-effect profiles. Rosiglitazone may increase total cholesterol compared to pioglitazone. Studies are needed which provide direct comparisons between the two drugs, particularly for long-term health outcomes.

Keywords: Type 2 diabetes; Oral hypoglycemic agents; Systematic review; Meta-analyisis

Document Type: Research article

DOI: http://dx.doi.org/10.2174/157339907780598216

Affiliations: 1: 3181 SW Sam Jackson Park Road, Mail Stop B1CC, Portland, OR 97239, USA.

Publication date: 2007-05-01

More about this publication?

• Current Diabetes Reviews publishes frontier reviews on all the latest advances on diabetes and its related areas e.g. pharmacology, pathogenesis, complications, epidemiology, clinical care, and therapy.
  
  The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians who are involved in the field of diabetes.

Related content

• In this: publication
• By this: publisher
• In this Subject: Medicine ,  Medicine (General)
• By this author: Norris, Susan L. ;  Carson, Susan ;  Roberts, Carol

Website © Publishing Technology. Article copyright remains with the publisher, society or author(s) as specified within the article.

• Terms and conditions
• Privacy policy
• Information for advertisers