Efficacy of low-dose pioglitazone in combination with exenatide on glucose control in patients with T2DM.

INTRODUCTION

Pioglitazone effectively reduces glycated hemoglobin (HbA1c) in patients with diabetes. The aim of the present study is to examine the safety and efficacy of lower doses of pioglitazone in combination with exenatide in EDICT and Qatar studies

RESEARCH DESIGN AND

METHODS

Newly diagnosed, drug-naïve patients were started on combination therapy with metformin, plus pioglitazone plus exenatide in the EDICT study. Poorly controlled patients with long-standing diabetes on the maximal dose of metformin plus sulfonylurea were started on a combination of pioglitazone plus exenatide. Patients in both studies were followed for 3 years. Patients were stratified according to the pioglitazone dose used, and the efficacy of HbA1c lowering, change in body weight, and incidence of ankle edema were related to pioglitazone dose.

RESULTS

The reduction in HbA1c was comparable in patients receiving 15, 30, and 45 mg of pioglitazone in both the EDICT and Qatar studies. However, the mean change in body weight was dose-dependent. Subjects receiving 15 mg of pioglitazone experienced a mean weight loss (~1.5 kg) in both studies compared with a mean weight gain in subjects receiving 30 and 45 mg doses (1–5 kg).

CONCLUSION

When combined with glucagon-like peptide-1 receptor agonist, the lower doses of pioglitazone produce a comparable reduction in HbA1c with a lower risk of weight gain than the maximal approved pioglitazone dose (45 mg), especially in individuals with obesity.