Kaplan-Meier analysis showed a cumulative incidence of monotherapy failure at 5 years of 15% with rosiglitazone, 21% with metformin, and 34% with glyburide. This represents a risk reduction of 32% for rosiglitazone, as compared with metformin, and 63%, as compared with glyburide (P<0.001 for both comparisons). The difference in the durability of the treatment effect was greater between rosiglitazone and glyburide than between rosiglitazone and metformin. Glyburide was associated with a lower risk of cardiovascular events (including congestive heart failure) than was rosiglitazone (P <0.05), and the risk associated with metformin was similar to that with rosiglitazone. Rosiglitazone was associated with more weight gain and edema than either metformin or glyburide but with fewer gastrointestinal events than metformin and with less hypoglycemia than glyburide (P<0.001 for both comparisons).
I'm Dr. Joshua Schwimmer, a nephrologist and internal medicine physician in New York City. • Kidney Notes was the first active nephrology blog. (Trivia: Kidney Notes is so old that the National Library of Medicine still uses it as an example of how to formally cite blogs.) • Professionally, you can find me at Kidney.nyc. • Kidney Notes is for educational purposes only, not medical advice. Consult qualified health care professionals. See disclaimer.
Monday, December 4, 2006
Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy
From the New England Journal of Medicine: