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Erschienen in: Drugs 11/2005

01.08.2005 | Adis Drug Profile

Rosiglitazone/Metformin

verfasst von: Keri Wellington

Erschienen in: Drugs | Ausgabe 11/2005

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Abstract

▴ The thiazolidinedione rosiglitazone and the biguanide metformin are effective antihyperglycaemic agents with different modes of action; rosiglitazone primarily increases insulin sensitivity, whereas metformin primarily reduces hepatic glucose output.
▴ Antihyperglycaemic combination therapy is often required to achieve effective glycaemic control. A fixed-dose formulation of rosiglitazone/metformin was recently approved in the EU and the US for the treatment of type 2 diabetes mellitus in patients inadequately controlled on metformin monotherapy.
▴ Bioequivalence between the fixed-dose combination tablet and coadministration of rosiglitazone with metformin at the same dosage has been established in a pharmacokinetic study.
▴ Fixed-dose rosiglitazone/metformin 8mg/2g per day reduced glycosylated haemoglobin (HbA1c) and fasting plasma glucose (FPG) levels to a significantly greater extent than metformin 3 g/day in patients with type 2 diabetes in a 24-week, randomised, double-blind study.
▴ Rosiglitazone plus metformin was significantly more effective than metformin alone at reducing HbA1c and FPG levels in patients with type 2 diabetes in three 26-week, randomised, double-blind, placebo-controlled studies.
▴ Rosiglitazone plus metformin was generally well tolerated in all studies and had a tolerability profile similar to that of metformin monotherapy. Mild or moderate symptomatic hypoglycaemia was reported in ≤4.4% of rosiglitazone plus metformin recipients.
Fußnoten
1
The use of trade names is for product identification purposes only and does not imply endorsement.
 
Literatur
1.
Zurück zum Zitat Hawkins D, Bradberry JC, Cziraky MJ, et al. National Pharmacy Cardiovascular Council treatment guidelines for the management of type 2 diabetes mellitus: toward better patient outcomes and new roles for pharmacists. Pharmacotherapy 2002 Apr; 22(4): 436–44PubMedCrossRef Hawkins D, Bradberry JC, Cziraky MJ, et al. National Pharmacy Cardiovascular Council treatment guidelines for the management of type 2 diabetes mellitus: toward better patient outcomes and new roles for pharmacists. Pharmacotherapy 2002 Apr; 22(4): 436–44PubMedCrossRef
2.
Zurück zum Zitat Wagstaff AJ, Goa KL. Rosiglitazone: a review of its use in the management of type 2 diabetes mellitus. Drugs 2002; 62(12): 1805–37PubMedCrossRef Wagstaff AJ, Goa KL. Rosiglitazone: a review of its use in the management of type 2 diabetes mellitus. Drugs 2002; 62(12): 1805–37PubMedCrossRef
3.
Zurück zum Zitat American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2005; 28 Suppl. 1: S37–42CrossRef American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2005; 28 Suppl. 1: S37–42CrossRef
4.
Zurück zum Zitat Dunn CJ, Peters DH. Metformin: a review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus. Drugs 1995 May; 49(5): 721–49PubMedCrossRef Dunn CJ, Peters DH. Metformin: a review of its pharmacological properties and therapeutic use in non-insulin-dependent diabetes mellitus. Drugs 1995 May; 49(5): 721–49PubMedCrossRef
5.
Zurück zum Zitat Hundal RS, Inzucchi SE. Metformin: new understandings, new uses. Drugs 2003; 63(18): 1879–94PubMedCrossRef Hundal RS, Inzucchi SE. Metformin: new understandings, new uses. Drugs 2003; 63(18): 1879–94PubMedCrossRef
6.
Zurück zum Zitat Cox SL. Rosiglitazone maleate/metformin hydrochloride: a new formulation therapy for type 2 diabetes. Drugs Today (Barc) 2004 Jul; 40(7): 633–43CrossRef Cox SL. Rosiglitazone maleate/metformin hydrochloride: a new formulation therapy for type 2 diabetes. Drugs Today (Barc) 2004 Jul; 40(7): 633–43CrossRef
7.
Zurück zum Zitat Vanderpoel DR, Hussein MA, Watson-Heidari T, et al. Adherence to a fixed-dose combination of rosiglitazone maleate/ metformin hydrochloride in subjects with type 2 diabetes mellitus: a retrospective database analysis. Clin Ther 2004 Dec; 26(12): 2066–75PubMedCrossRef Vanderpoel DR, Hussein MA, Watson-Heidari T, et al. Adherence to a fixed-dose combination of rosiglitazone maleate/ metformin hydrochloride in subjects with type 2 diabetes mellitus: a retrospective database analysis. Clin Ther 2004 Dec; 26(12): 2066–75PubMedCrossRef
8.
Zurück zum Zitat Del Prato S, Volpe L. Rosiglitazone plus metformin: combination therapy for type 2 diabetes. Expert Opin Pharmacother 2004; 5(6): 1411–22PubMedCrossRef Del Prato S, Volpe L. Rosiglitazone plus metformin: combination therapy for type 2 diabetes. Expert Opin Pharmacother 2004; 5(6): 1411–22PubMedCrossRef
9.
Zurück zum Zitat Kunhiraman B, Itoua-Nganongo W, Fonseca V. Avandamet. Br J Diabetes Vasc Dis 2004; 4: 268–71CrossRef Kunhiraman B, Itoua-Nganongo W, Fonseca V. Avandamet. Br J Diabetes Vasc Dis 2004; 4: 268–71CrossRef
10.
Zurück zum Zitat Diamant M, Heine RJ. Thiazolidinediones in type 2 diabetes mellitus: current clinical evidence. Drugs 2003; 63(13): 1373–405PubMedCrossRef Diamant M, Heine RJ. Thiazolidinediones in type 2 diabetes mellitus: current clinical evidence. Drugs 2003; 63(13): 1373–405PubMedCrossRef
11.
Zurück zum Zitat Bailey CJ, Day C. Avandamet: combined metformin-rosiglitazone treatment for insulin resistance in type 2 diabetes. Int J Clin Pract 2004 Sep; 58(9): 867–76PubMedCrossRef Bailey CJ, Day C. Avandamet: combined metformin-rosiglitazone treatment for insulin resistance in type 2 diabetes. Int J Clin Pract 2004 Sep; 58(9): 867–76PubMedCrossRef
12.
Zurück zum Zitat Karlsson HKR, Hällsten K, Björnholm M, et al. Effects of metformin and rosiglitazone treatment on insulin signaling and glucose uptake in patients with newly diagnosed type 2 diabetes: a randomized controlled study. Diabetes 2005 May; 54(5): 1459–67PubMedCrossRef Karlsson HKR, Hällsten K, Björnholm M, et al. Effects of metformin and rosiglitazone treatment on insulin signaling and glucose uptake in patients with newly diagnosed type 2 diabetes: a randomized controlled study. Diabetes 2005 May; 54(5): 1459–67PubMedCrossRef
13.
Zurück zum Zitat Shargorodsky M, Wainstein G, Gavish E, et al. Treatment with rosiglitazone reduces hyperinsulinemia and improves arterial elasticity in patients with type 2 diabetes mellitus. Am J Hypertens 2003 Aug; 16(8): 617–22PubMedCrossRef Shargorodsky M, Wainstein G, Gavish E, et al. Treatment with rosiglitazone reduces hyperinsulinemia and improves arterial elasticity in patients with type 2 diabetes mellitus. Am J Hypertens 2003 Aug; 16(8): 617–22PubMedCrossRef
14.
Zurück zum Zitat Ovalle F, Bell DSH. Effect of rosiglitazone versus insulin on the pancreatic β-cell function of subjects with type 2 diabetes. Diabetes Care 2004 Nov; 27(11): 2585–9PubMedCrossRef Ovalle F, Bell DSH. Effect of rosiglitazone versus insulin on the pancreatic β-cell function of subjects with type 2 diabetes. Diabetes Care 2004 Nov; 27(11): 2585–9PubMedCrossRef
15.
Zurück zum Zitat Lupi R, Del Guerra S, Marselli L, et al. Rosiglitazone prevents the impairment of human islet function induced by fatty acids: evidence for a role of PPARγ2 in the modulation of insulin secretion. Am J Physiol Endocrinol Metab 2004 Apr; 286(4): E560–7PubMedCrossRef Lupi R, Del Guerra S, Marselli L, et al. Rosiglitazone prevents the impairment of human islet function induced by fatty acids: evidence for a role of PPARγ2 in the modulation of insulin secretion. Am J Physiol Endocrinol Metab 2004 Apr; 286(4): E560–7PubMedCrossRef
16.
Zurück zum Zitat Tiikkainen M, Häkkinen A-M, Korsheninnikova E, et al. Effects of rosiglitazone and metformin on liver fat content, hepatic insulin resistance, insulin clearance, and gene expression in adipose tissue in patients with type 2 diabetes. Diabetes 2004 Aug; 53(8): 2169–76PubMedCrossRef Tiikkainen M, Häkkinen A-M, Korsheninnikova E, et al. Effects of rosiglitazone and metformin on liver fat content, hepatic insulin resistance, insulin clearance, and gene expression in adipose tissue in patients with type 2 diabetes. Diabetes 2004 Aug; 53(8): 2169–76PubMedCrossRef
17.
Zurück zum Zitat Haffner SM, Greenberg AS, Weston WM, et al. Effect of rosiglitazone treatment on nontraditional markers of cardiovascular disease in patients with type 2 diabetes mellitus. Circulation 2002 Aug 6; 106(6): 679–84PubMedCrossRef Haffner SM, Greenberg AS, Weston WM, et al. Effect of rosiglitazone treatment on nontraditional markers of cardiovascular disease in patients with type 2 diabetes mellitus. Circulation 2002 Aug 6; 106(6): 679–84PubMedCrossRef
18.
Zurück zum Zitat Marx N, Froehlich J, Siam L, et al. Antidiabetic PPARγ-activator rosiglitazone reduces MMP-9 serum levels in type 2 diabetic patients with coronary artery disease. Arterioscler Thromb Vasc Biol 2003 Feb; 23: 283–8PubMedCrossRef Marx N, Froehlich J, Siam L, et al. Antidiabetic PPARγ-activator rosiglitazone reduces MMP-9 serum levels in type 2 diabetic patients with coronary artery disease. Arterioscler Thromb Vasc Biol 2003 Feb; 23: 283–8PubMedCrossRef
19.
Zurück zum Zitat Marx N, Imhof A, Froehlich J, et al. Effect of rosiglitazone treatment on soluble CD40L in patients with type 2 diabetes and coronary artery disease. Circulation 2003 Apr 22; 107: 1954–7PubMedCrossRef Marx N, Imhof A, Froehlich J, et al. Effect of rosiglitazone treatment on soluble CD40L in patients with type 2 diabetes and coronary artery disease. Circulation 2003 Apr 22; 107: 1954–7PubMedCrossRef
20.
Zurück zum Zitat Yosefy C, Magen E, Kiselevich A, et al. Rosiglitazone improves, while glibenclamide worsens blood pressure control in treated hypertensive diabetic and dyslipidemic subjects via modulation of insulin resistance and sympathetic activity. J Cardiovasc Pharmacol 2004 Aug; 44(2): 215–22PubMedCrossRef Yosefy C, Magen E, Kiselevich A, et al. Rosiglitazone improves, while glibenclamide worsens blood pressure control in treated hypertensive diabetic and dyslipidemic subjects via modulation of insulin resistance and sympathetic activity. J Cardiovasc Pharmacol 2004 Aug; 44(2): 215–22PubMedCrossRef
21.
Zurück zum Zitat Sarafidis PA, Lasaridis AN, Nilsson PM, et al. Ambulatory blood pressure reduction after rosiglitazone treatment in patients with type 2 diabetes and hypertension correlates with insulin sensitivity increase. J Hypertens 2004 Sep; 22(9): 1769–77PubMedCrossRef Sarafidis PA, Lasaridis AN, Nilsson PM, et al. Ambulatory blood pressure reduction after rosiglitazone treatment in patients with type 2 diabetes and hypertension correlates with insulin sensitivity increase. J Hypertens 2004 Sep; 22(9): 1769–77PubMedCrossRef
22.
Zurück zum Zitat Natali A, Baldeweg S, Toschi E, et al. Vascular effects of improving metabolic control with metformin or rosiglitazone in type 2 diabetes. Diabetes Care 2004 Jun; 27(6): 1349–57PubMedCrossRef Natali A, Baldeweg S, Toschi E, et al. Vascular effects of improving metabolic control with metformin or rosiglitazone in type 2 diabetes. Diabetes Care 2004 Jun; 27(6): 1349–57PubMedCrossRef
23.
Zurück zum Zitat Honisett SY, Stojanovska L, Sudhir K, et al. Rosiglitazone lowers blood pressure and increases arterial compliance in postmenopausal women with type 2 diabetes [letter]. Diabetes Care 2003 Nov; 26(11): 3194–5PubMedCrossRef Honisett SY, Stojanovska L, Sudhir K, et al. Rosiglitazone lowers blood pressure and increases arterial compliance in postmenopausal women with type 2 diabetes [letter]. Diabetes Care 2003 Nov; 26(11): 3194–5PubMedCrossRef
24.
Zurück zum Zitat Regensteiner JG, Bauer TA, Reusch JB. Rosiglitazone improves exercise capacity in type 2 diabetes (T2DM) [abstract no. 35-OR]. Diabetes 2004 Jun; 53 Suppl. 2: A8–9 Regensteiner JG, Bauer TA, Reusch JB. Rosiglitazone improves exercise capacity in type 2 diabetes (T2DM) [abstract no. 35-OR]. Diabetes 2004 Jun; 53 Suppl. 2: A8–9
25.
Zurück zum Zitat Petrofsky JS, Bweir SO, Lee SW, et al. Rosiglitazone improves age related reductions in forearm resting flows and endothelial dysfunction observed in type 2 diabetes [abstract no. P3022]. Eur Heart J 2004; 25 (Abstr. Suppl.): 512–3 Petrofsky JS, Bweir SO, Lee SW, et al. Rosiglitazone improves age related reductions in forearm resting flows and endothelial dysfunction observed in type 2 diabetes [abstract no. P3022]. Eur Heart J 2004; 25 (Abstr. Suppl.): 512–3
26.
Zurück zum Zitat Fonseca V, Rosenstock J, Patwardhan R, et al. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: a randomized controlled trial. JAMA 2000 Apr 5; 283(13): 1695–702PubMedCrossRef Fonseca V, Rosenstock J, Patwardhan R, et al. Effect of metformin and rosiglitazone combination therapy in patients with type 2 diabetes mellitus: a randomized controlled trial. JAMA 2000 Apr 5; 283(13): 1695–702PubMedCrossRef
27.
Zurück zum Zitat Gómez-Perez FJ, Fanghänel-Salmón G, Antonio Barbosa J, et al. Efficacy and safety of rosiglitazone plus metformin in Mexicans with type 2 diabetes. Diabetes Metab Res Rev 2002; 18: 127–34PubMedCrossRef Gómez-Perez FJ, Fanghänel-Salmón G, Antonio Barbosa J, et al. Efficacy and safety of rosiglitazone plus metformin in Mexicans with type 2 diabetes. Diabetes Metab Res Rev 2002; 18: 127–34PubMedCrossRef
28.
Zurück zum Zitat GlaxoSmithKline. Avandamet® (rosiglitazone maleate and metformin hydrochloride) tablets [online]. Available from URL: http://us.gsk.com [Accessed 2005 May 4] GlaxoSmithKline. Avandamet® (rosiglitazone maleate and metformin hydrochloride) tablets [online]. Available from URL: http://​us.​gsk.​com [Accessed 2005 May 4]
29.
Zurück zum Zitat Zarich SW. Treating the diabetic patient: appropriate care for glycemic control and cardiovascular disease risk factors. Rev Cardiovasc Med 2003; 4 Suppl. 6: S19–8PubMed Zarich SW. Treating the diabetic patient: appropriate care for glycemic control and cardiovascular disease risk factors. Rev Cardiovasc Med 2003; 4 Suppl. 6: S19–8PubMed
30.
Zurück zum Zitat Sivitz WI. Lipotoxicity and glucotoxicity in type 2 diabetes: effects on development and progression. Postgrad Med 2001 Apr; 109(4): 55–9, 63-4PubMedCrossRef Sivitz WI. Lipotoxicity and glucotoxicity in type 2 diabetes: effects on development and progression. Postgrad Med 2001 Apr; 109(4): 55–9, 63-4PubMedCrossRef
31.
Zurück zum Zitat Lupi R, Del Guerra S, Fierabracci V, et al. Lipotoxicity in human pancreatic islets and the protective effect of metformin. Diabetes 2002 Feb; 51 Suppl. 1: S134–7PubMedCrossRef Lupi R, Del Guerra S, Fierabracci V, et al. Lipotoxicity in human pancreatic islets and the protective effect of metformin. Diabetes 2002 Feb; 51 Suppl. 1: S134–7PubMedCrossRef
32.
Zurück zum Zitat Weissman PN, Goldstein BJ, Campbell JC, et al. Rosiglitazone plus metformin combination effects on CV risk markers suggest potential CV benefits in type 2 diabetic patients [abstract no. 121-OR]. Diabetes 2004 Jun; 53 Suppl. 2: 28 Weissman PN, Goldstein BJ, Campbell JC, et al. Rosiglitazone plus metformin combination effects on CV risk markers suggest potential CV benefits in type 2 diabetic patients [abstract no. 121-OR]. Diabetes 2004 Jun; 53 Suppl. 2: 28
33.
Zurück zum Zitat Derosa G, Gaddi AV, Piccinni MN, et al. Antithrombotic effects of rosiglitazone-metformin versus glimepiride-metformin combination therapy in patients with type 2 diabetes mellitus and metabolic syndrome. Pharmacotherapy 2005 May; 25(5): 637–45PubMedCrossRef Derosa G, Gaddi AV, Piccinni MN, et al. Antithrombotic effects of rosiglitazone-metformin versus glimepiride-metformin combination therapy in patients with type 2 diabetes mellitus and metabolic syndrome. Pharmacotherapy 2005 May; 25(5): 637–45PubMedCrossRef
34.
Zurück zum Zitat Bakris GL, Ruilope LM, Weston WM, et al. Rosiglitazone (RSG) added to metformin (MET) reduces urinary albumin/ creatinine ratio and ambulatory blood pressure in subjects with microalbuminuria and type 2 diabetes (T2DM) [abstract no. 543-P]. Diabetes 2005 Jun; 54 Suppl. 1: A134 Bakris GL, Ruilope LM, Weston WM, et al. Rosiglitazone (RSG) added to metformin (MET) reduces urinary albumin/ creatinine ratio and ambulatory blood pressure in subjects with microalbuminuria and type 2 diabetes (T2DM) [abstract no. 543-P]. Diabetes 2005 Jun; 54 Suppl. 1: A134
35.
Zurück zum Zitat Di Cicco RA, Allen A, Carr A, et al. Rosiglitazone does not alter the pharmacokinetics of metformin. J Clin Pharmacol 2000 Nov; 40(11): 1280–5 Di Cicco RA, Allen A, Carr A, et al. Rosiglitazone does not alter the pharmacokinetics of metformin. J Clin Pharmacol 2000 Nov; 40(11): 1280–5
37.
Zurück zum Zitat Cox PJ, Ryan DA, Hollis FJ, et al. Absorption, disposition, and metabolism of rosiglitazone, a potent thiazolidinedione insulin sensitizer, in humans. Drug Metab Dispos 2000 Jul; 28(7): 772–80PubMed Cox PJ, Ryan DA, Hollis FJ, et al. Absorption, disposition, and metabolism of rosiglitazone, a potent thiazolidinedione insulin sensitizer, in humans. Drug Metab Dispos 2000 Jul; 28(7): 772–80PubMed
39.
Zurück zum Zitat Stewart M, Bailey C, Andrew D, et al. Rosiglitazone/metformin (RSG/MET) fixed dose combination (AVM) is associated with attainment of glycaemic targets for a greater proportion of patients with type 2 diabetes (T2DM) than uptitrated MET. Diabet Med 2005; 22 Suppl. 2: 48. Plus poster presented at the Diabetes UK Annual Professional Conference; 2005 Apr 20–22; Glasgow Stewart M, Bailey C, Andrew D, et al. Rosiglitazone/metformin (RSG/MET) fixed dose combination (AVM) is associated with attainment of glycaemic targets for a greater proportion of patients with type 2 diabetes (T2DM) than uptitrated MET. Diabet Med 2005; 22 Suppl. 2: 48. Plus poster presented at the Diabetes UK Annual Professional Conference; 2005 Apr 20–22; Glasgow
40.
Zurück zum Zitat Rosenstock J, Stow L, Rood J, et al. Rosiglitazone/metformin (RSG/MET) fixed dose combination (FDC) is effective and well-tolerated in drug-naive type 2 diabetes mellitus (T2DM) subjects with severe hyerglycemia [abstract no. 515-P]. Diabetes 2005 Jun; 54 Suppl. 1: A127 Rosenstock J, Stow L, Rood J, et al. Rosiglitazone/metformin (RSG/MET) fixed dose combination (FDC) is effective and well-tolerated in drug-naive type 2 diabetes mellitus (T2DM) subjects with severe hyerglycemia [abstract no. 515-P]. Diabetes 2005 Jun; 54 Suppl. 1: A127
41.
Zurück zum Zitat Maheux P, Berry RA, Warsi G, et al. Rosiglitazone-metformin combination improves glycemic control in patients with type 2 diabetes [poster no. 168]. 5th Annual Professional Conference of the Canadian Diabetes Association and the Canadian Society of Endocrinology and Metabolism CDA/CSEM; 2001 Oct 17–20; Edmonton, 168 Maheux P, Berry RA, Warsi G, et al. Rosiglitazone-metformin combination improves glycemic control in patients with type 2 diabetes [poster no. 168]. 5th Annual Professional Conference of the Canadian Diabetes Association and the Canadian Society of Endocrinology and Metabolism CDA/CSEM; 2001 Oct 17–20; Edmonton, 168
42.
Zurück zum Zitat Garber A, Sankoh S, Mohideen P, et al. Glyburide/metformin tablets versus metformin plus rosiglitazone in type 2 diabetes patients uncontrolled on metformin: attaining glycemic goals [abstract no. 513-P]. Diabetes 2003 Jun; 52 Suppl. 1: 119–20. Plus poster presented at the 63rd Annual Scientific Sessions of the American Diabetes Association; 2003 Jun 13–17; New Orleans Garber A, Sankoh S, Mohideen P, et al. Glyburide/metformin tablets versus metformin plus rosiglitazone in type 2 diabetes patients uncontrolled on metformin: attaining glycemic goals [abstract no. 513-P]. Diabetes 2003 Jun; 52 Suppl. 1: 119–20. Plus poster presented at the 63rd Annual Scientific Sessions of the American Diabetes Association; 2003 Jun 13–17; New Orleans
43.
Zurück zum Zitat Home PD, Pocock S, Beck-Nielsen H, et al. Rosiglitazone evaluated for cardiac outcomes and regulation of glycaemia in diabetes (RECORD): an interim analysis of glycaemia at 18 months [poster no. 725]. 40th Annual Meeting of the European Association for the Study of Diabetes; 2004 Sep 5–9; Munich Home PD, Pocock S, Beck-Nielsen H, et al. Rosiglitazone evaluated for cardiac outcomes and regulation of glycaemia in diabetes (RECORD): an interim analysis of glycaemia at 18 months [poster no. 725]. 40th Annual Meeting of the European Association for the Study of Diabetes; 2004 Sep 5–9; Munich
Metadaten
Titel
Rosiglitazone/Metformin
verfasst von
Keri Wellington
Publikationsdatum
01.08.2005
Verlag
Springer International Publishing
Erschienen in
Drugs / Ausgabe 11/2005
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200565110-00013

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