Rosiglitazone decreases C-reactive protein to a greater extent relative to glyburide and metformin over 4 years despite greater weight gain: observations from a Diabetes Outcome Progression Trial (ADOPT).

Description

The purpose of this study was to investigate the long-term effects of rosiglitazone, glyburide, or metformin in drug-naive patients with newly diagnosed type 2 diabetes. The authors performed a subgroup analysis (n=904 subjects) of ADOPT (A Diabetes Outcome Progression Trial), a randomized, double-blind, controlled trial including >4000 patients, treated for an average of 4 years. The results showed a greater reduction in C-Reactive Protein (CRP) in patients treated with rosiglitazone compared the patients treated with either glyburide or metformin. Moreover, the rapid and durable reduction in CRP was similar in both men and women and was independent of changes in insulin sensitivity, HbA1c, and body weight gain. In contrast, treatment with glyburide and metformin was associated with a moderate and gradual reduction in CRP and was partly associated with changes in body weight but independent of glycemic control and insulin sensitivity. More studies are needed to determine the contribution of CRP reduction by glucose-lowering therapy to the risk of future cardiovascular events in patients with type 2 diabetes.