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Effect of diabetes drugs
In a 18-month study comparing the effects of two diabetes drugs in patients with type 2 diabetes, one drug appeared to stop progression of artery narrowing, researchers reported at the American Heart Association's Scientific Sessions.
Researchers presented results of the Carotid Intima-Media THICkness in Atherosclerosis Using PioGlitazOne (Chicago) study in a late-breaking clinical trials session.
Carotid intima-media thickness (CIMT) is the thickness of the inner lining of neck arteries that carry blood to the brain and is a marker of the extent of artery-clogging plaque (atherosclerosis) throughout the body.
Chicago is a phase IIIb, multicenter, double-blind, randomized, two-arm study comparing pioglitazone to glimepiride. Piogllitazone, a drug in a class of drugs called thiasolidinediones, makes muscles and fat tissue more sensitive to insulin, the substance that helps break down sugar in the blood. The other drug, glimepiride, is a sulfonylurea drug -- a class of drug that stimulates insulin secretion. Chicago is the largest and longest CIMT study.
"From baseline to the final visit, there was a significant difference in CIMT in favor of the pioglitazone group," said Theodore Mazzone, M.D., chairman of the trial and chief of Endocrinology, Diabetes and Metabolism in the Department of Medicine at the University of Illinois in Chicago. "Over the 18-month treatment period, the glimepiride group's CIMT continued to progress whereas progression was virtually arrested in the pioglitazone group."
The Chicago study included 462 patients with type 2 diabetes (ages 45-85) recruited from the multi-racial/ethnic population of the Chicago area. In type 2 diabetes, the body produces insulin but fails to use it efficiently to metabolize blood sugar. Doctors in this study could add insulin or metformin in addition to the investigational drugs, if necessary, to keep blood sugar in check, Mazzone said.
Researchers randomly assigned patients to receive one of three doses of pioglitazone or one of three does of glimepiride. After 18 months, the researchers measured the absolute change in CIMT.
"If supported by additional research, these findings would indicate that pioglitazone can delay the progression of atherosclerosis in patients with diabetes," Mazzone said.