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Rosiglitazone, Pioglitazone Safe for Type 2 Diabetes , But Effect on Lipid Levels Should Be Considered
A DGReview of :"Differences in lipid profiles of patients given rosiglitazone followed by pioglitazone."
Current Medical Research and Opinion
12/06/2002
By Veronica Rose
Both rosiglitazone and pioglitazone are safe and well tolerated for the treatment of diabetes type 2.
However, researchers at the University of Texas Diabetes Institute in San Antonio, Texas, United States, caution that because diabetic patients are at risk for coronary artery disease, doctors should consider the effects of each agent on lipid levels when choosing a specific thiazolidinedione.
Twenty patients with diabetes type 2, were treated with both therapeutic agents for a period of three months. The patients had been treated with rosiglitazone at 4 mg twice a day for three months or longer, and then switched to pioglitazone 45 mg once daily for the same period.
Glycaemic control proved excellent, and was essentially equivalent throughout the use of two therapies, according to researchers. The mean Hb A1c level was 7.6 percent at baseline. This dropped to 6.6 percent with rosiglitazone, and 6.3 percent with pioglitazone.
However, the researchers found differences in lipid levels between the two therapies. During treatment with rosiglitazone the triglyceride levels rose 13 percent, but with pioglitazone it fell below the baseline levels with an overall reduction of 24 percent.
There was an association between rosiglitazone and increased low-density lipoprotein cholesterol levels of 35 percent, and significantly increased total cholesterol levels of 22 percent. However with pioglitazone, the levels of LDL-C fell 25 percent and total cholesterol dropped 19 percent.
Researchers found that HDL-C Levels showed no significant alteration during either treatment.
Oedema developed in one patient receiving rosiglitazone, and another receiving pioglitazone; both cases resolved without discontinuing the treatments. Furthermore "liver enzyme levels and blood pressure were unaffected in this group," say researchers.
Current Medical Research Opinion 2002; 18:6:363-370.
"Differences in lipid profiles of patients given rosiglitazone followed by pioglitazone."
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