The new clinical trials with thiazolidinediones - DREAM, ADOPT, and CHICAGO: Promises fulfilled?

Research output: Contribution to journalReview article

19 Scopus citations

Abstract

PURPOSE OF REVIEW: Despite extensive documentation of their insulin-sensitizing and antihyperglycemic effects, the importance and place of the thiazolidinediones in diabetes management remain unclear. Three new controlled clinical trials of thiazolidinediones offer new information on the clinical utility of these agents. RECENT FINDINGS: During the past year, three new trials of thiazolidinediones were reported. In Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication, rosiglitazone reduced progression to diabetes in prediabetic patients by 60%. A Diabetes Outcome Progression Trial found rosiglitazone to have greater antihyperglycemic durability than metformin and glyburide in patients with recently diagnosed type 2 diabetes. Finally, in the Carotid Intima-media Thickness in Atherosclerosis using Pioglitazone, treatment with pioglitazone in patients with type 2 diabetes slowed progression of carotid wall thickness compared with the sulfonylurea glimepiride. SUMMARY: These trials support the contention that thiazolidinediones have superior efficacy in improving and stabilizing glycemic control than older antihyperglycemic agents, especially early in the course of type 2 diabetes. Findings from the Carotid Intima-media Thickness in Atherosclerosis using Pioglitazone add to the evidence that these agents have clinically meaningful vasculoprotective effects. Although generally well tolerated, they promote weight gain, limiting their acceptability to some extent, and occasionally lead to a diagnosis of heart failure, mostly in susceptible individuals.

Original languageEnglish (US)
Pages (from-to)435-442
Number of pages8
JournalCurrent Opinion in Lipidology
Volume18
Issue number4
DOIs
StatePublished - Aug 1 2007

Keywords

  • Clinical trial
  • Diabetes management
  • Thiazolidinedione

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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