Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

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Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43 Steven E. Kahn, M.B., Ch.B., Steven M. Haffner, M.D., Mark A. Heise, Ph.D., William H. Herman, M.D., M.P.H., Rury R. Holman, F.R.C.P., Nigel P. Jones, M.A., Barbara G. Kravitz, M.S., John M. Lachin, Sc.D., M. Colleen O'Neill, B.Sc., Bernard Zinman, M.D., F.R.C.P.C., Giancarlo Viberti, M.D., F.R.C.P., for the ADOPT Study Group Study Overview This double-blind, randomized, controlled trial evaluated rosiglitazone, metformin, and glyburide as an initial treatment in patients with type 2 diabetes Rosiglitazone reduced the risk of treatment failure (the primary outcome) by 32% as compared with metformin and by 63% as compared with glyburide The potential risks, benefits, and costs of these medications should all be considered to help inform the choice of pharmacotherapy for patients with type 2 diabetes

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Page 1: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Glycemic Durability of Rosiglitazone, Metformin, or Glyburide Monotherapy

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Steven E. Kahn, M.B., Ch.B., Steven M. Haffner, M.D., Mark A. Heise, Ph.D., William H. Herman, M.D., M.P.H., Rury R. Holman, F.R.C.P., Nigel P. Jones, M.A., Barbara G. Kravitz, M.S., John M. Lachin, Sc.D., M. Colleen O'Neill, B.Sc., Bernard Zinman, M.D., F.R.C.P.C., Giancarlo Viberti, M.D., F.R.C.P., for the ADOPT Study Group

Study Overview

This double-blind, randomized, controlled trial evaluated rosiglitazone, metformin, and glyburide as an initial treatment in patients with type 2 diabetes

Rosiglitazone reduced the risk of treatment failure (the primary outcome) by 32% as compared with metformin and by 63% as compared with glyburideThe potential risks, benefits, and costs of these medications

should all be considered to help inform the choice of pharmacotherapy for patients with type 2 diabetes

Page 2: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Enrollment and Outcomes

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 3: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Baseline Characteristics of the Patients* - Part I

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 4: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Baseline Characteristics of the Patients* - Part II

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 5: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Kaplan-Meier Estimates of the Cumulative Incidence of Monotherapy Failure at 5 Years

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 6: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Hazard Ratio for Monotherapy Failure in the Rosiglitazone Group, as Compared with the Metformin and Glyburide

Groups in Key Subgroups

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 7: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Fasting Plasma Glucose (Panel A), Glycated Hemoglobin (Panel B), Insulin Sensitivity (Panel C), β-Cell Function (Panel D), over Time,

According to Treatment Group

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

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Weight (Panel E), Waist Circumference (Panel F), Hip Circumference (Panel G),

and Waist-to-Hip Ratio (Panel H) over Time, According to Treatment Group

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 9: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Adverse Events, Laboratory Assessment, Concomitant Use of Cardiovascular Drugs,

Hospitalization, and Death* - Part I

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 10: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Adverse Events, Laboratory Assessment, Concomitant Use of Cardiovascular Drugs,

Hospitalization, and Death* - Part II

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43

Page 11: Glycemic Durability of Rosiglitazone,  Metformin, or Glyburide Monotherapy

Rate of Fractures

Kahn SE, et al. (ADOPT Study Group) N Engl J Med 2006;355:2427-43