Porównanie monoterapii repaglinidem i nateglinidem. Wieloośrodkowe badanie randomizowane
2004
INTRODUCTION. A randomized, parallel-group, openlabel, multicenter 16-week
clinical trial compared efficacy and safety of repaglinide monotherapy and nateglinide
monotherapy in type 2 diabetic patients previously treated with diet and exercise. MATERIAL AND METHODS. Enrolled patients (n = 150) had received treatment
with diet and exercise in the previous 3 months with HbA1c > 7 and ≤ 12%. Patients
were randomized to receive monotherapy with repaglinide (n = 76) (0.5 mg/meal,
maximum dose 4 mg/meal) or nateglinide (n = 74) (60 mg/meal, maximum dose 120
mg/meal) for 16 weeks. Primary and secondary efficacy end points were changes
in HbA 1c and fasting plasma glucose (FPG) values from baseline, respectively.
Postprandial glucose, insulin, and glucagon were assessed after a liquid test
meal (baseline, week 16). Safety was assessed by incidence of adverse events or
hypoglycemia. RESULTS. Mean baseline HbA 1c values were similar in both groups (8.9%).
Final HbA1c values were lower for repaglinide monotherapy than nateglinide monotherapy
(7.3 vs. 7.9%). Mean final reductions of HbA 1c were significantly greater for
repaglinide monotherapy than nateglinide monotherapy (–1.57 vs. –1.04%; P = 0.002).
Mean changes in FPG also demonstrated significantly greater efficacy for repaglinide
than nateglinide (–57 vs. –18 mg/dl; P 1c values CONCLUSIONS. In patients previously treated with diet and exercise, repaglinide
and nateglinide had similar postprandial glycemic effects, but repaglinide monotherapy
was significantly more effective than nateglinide monotherapy in reducing HbA 1c
and FPG values after 16 weeks of therapy.
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