Repaglinide superior to nateglinide for controling diabetes in Japanese
MedWire News: Repaglinide is more effective than nateglinide at improving blood glucose control in Japanese Type 2 diabetes patients previously treated with diet and exercise, study findings show.
The superior glucose-lowering effects of repaglinide were also achieved without causing any increase in adverse events, say Ryuzo Kawamori (Juntendo University Graduate School of Medicine, Tokyo, Japan) and colleagues.
The authors say the purpose of the study was to confirm the superiority of repaglinide, a short-acting insulin secretagogue, over nateglinide - an existing drug of the same class with established efficacy and safety.
The team randomly assigned 130 Japanese diabetes patients who had previously been treated with 8 weeks of diet and exercise interventions to receive 0.5 mg repaglinide or 90 mg nateglinide three times daily for a period of 12 weeks.
The primary end point was change in glycated hemoglobin (HbA1c) from baseline to the end of treatment.
The authors note that the Japanese Diabetes Society recommends setting a treatment goal of achieving "excellent or good" blood glucose control (HbA1c <6.9%) when intervention is made for the purpose of preventing the onset or suppression of the progression of microangiopathy.
The proportion of patients who achieved a target HbA1c value of less than 6.9% was therefore also evaluated.
As reported in the Journal of Diabetes Investigation, the mean decrease in HbA1c at the end of the study was significantly greater in the repaglinide group than in the nateglinide group (1.17 vs 0.81%).
The authors found that the proportion of patients who achieved the target HbA1c value of less than 6.9% was also higher in the repaglinide than the nateglinide group (75.0 vs 59.1%).
In addition, the proportion of individuals who achieved an HbA1c value of less than 6.2% was more than three times higher in the repaglinide group (29.7 vs 9.1%).
"The results suggest that treatment with repaglinide is expected to suppress the onset and progression of diabetic complications classified as microangiopathy," say the authors.
The study also revealed that there were no differences in the adverse event rates between the repaglinide group and the nateglinide group (57.8 vs 60.6%).
The findings show the superiority of repaglinide over nateglinide, write Kawamori et al.
"Repaglinide can provide a new alternative treatment to an extensive range of patients with Type 2 diabetes in Japan," they conclude.
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By Sally Robertson