Effects of Pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type 2 diabetes mellitus: A retrospective review of randomly selected medical records

• Published in: Clinical therapeutics Vol. 24; no. 3; pp. 378 - 396
• Main Authors: Boyle, Patrick J., King, Allen Bennett, Olansky, Leann, Marchetti, Albert, Lau, Helen, Magar, Raf, Martin, John
• Format: Journal Article
• Language: English
• Published: Belle Mead, NJ EM Inc USA 01.03.2002; Excerpta Medica
• Subjects: Adult; Aged; Biological and medical sciences; Blood Glucose - metabolism; blood lipids; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Female; General and cellular metabolism. Vitamins; glycemic control; Humans; hyperglycemia; hyperlipidemia; Hypoglycemic Agents - adverse effects; Hypoglycemic Agents - therapeutic use; Lipids - blood; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Retrospective Studies; Sample Size; Thiazoles - adverse effects; Thiazoles - therapeutic use; Thiazolidinediones; type 2 diabetes; thiazolidinediones; hyperglycemia; hyperlipidemia; type 2 diabetes; glycemic control; blood lipids; Endocrinopathy; Human; Chemotherapy; Hypoglycemic agent; Treatment; Pioglitazone; Rosiglitazone; Lipids; Thiazolidinedione derivatives; Non insulin dependent diabetes; Glycemia
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/S0149-2918(02)85040-8

Background: The antihyperglycemic effects of pioglitazone hydrochloride and rosiglitazone maleate are well documented. The results of clinical trials and observational studies have suggested, however, that there are individual differences in the effects of these drugs on blood lipid levels. Objective: The present study evaluated the effects of pioglitazone and rosiglitazone on blood lipid levels and glycemic control in patients with type 2 diabetes mellitus. Methods: This was a retrospective review of randomly selected medical records from 605 primary care practices in the United States in which adults with type 2 diabetes received pioglitazone or rosiglitazone between August 1, 1999, and August 31, 2000. The outcome measures were mean changes in serum concentrations of triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and glycosylated hemoglobin (HbA 1c) values. Results: Treatment with pioglitazone was associated with a reduction in mean TG of 55.17 mg/dL, a reduction in TC of 8.45 mg/dL, an increase in HDL-C of 2.65 mg/dL, and a reduction in LDL-C of 5.05 mg/dL. Treatment with rosiglitazone was associated with a reduction in mean TG of 13.34 mg/dL, an increase in TC of 4.81 mg/dL, a reduction in HDL-C of 0.12 mg/dL, and an increase in LDL-C of 3.56 mg/dL. With the exception of HDL-C, the differences in mean changes in lipid parameters between treatment groups were statistically significantly ( P < 0.001, pioglitazone vs rosiglitazone). Reductions in HbA 1c were statistically equivalent between treatments (1.04% pioglitazone, 1.18% rosiglitazone). Conclusions: Treatment with pioglitazone was associated with greater beneficial effects on blood lipid levels than treatment with rosiglitazone, whereas glycemic control was equivalent between the 2 treatments.