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Low-Dose Rosiglitazone and Metformin as Preventives for Diabetes
Giving patients with impaired glucose tolerance a two-drug combination dramatically lowers their risk for developing type 2 diabetes, according to an industry-funded Lancet study. However, there is concern over long-term effects from this approach.
Canadian researchers randomized 200 patients to receive either a low-dose combination of rosiglitazone (2 mg) and metformin (500 mg) twice daily or a matching placebo. Treatment continued for roughly 4 years. By study's end, significantly fewer patients in the intervention group had developed diabetes (14% vs. 39%). The authors calculate a number needed to treat of 4, but they warn that they did not study the regimen's long-term cardiovascular safety.
Asked to comment, Journal Watch Cardiology's Dr. Harlan Krumholz said: "This study assumes that better glucose tolerance with this regimen will translate into better clinical outcomes. With rosiglitazone under a cloud of suspicion for increasing cardiovascular risk, clinicians should not move this strategy into practice."
LINK(S):
Lancet article (Free abstract; full text requires subscription)
Lancet comment (Subscription required)
Published in Physician's First Watch June 3, 2010
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