Comparison of vildagliptin and rosiglitazone monotherapy in patients with type 2 diabetes - A 24-week, double-blind, randomized trial

OBJECTIVE-To compare the efficacy and tolerability of vildagliptin and rosightazone during a 24-week treatment in drug-naive patients with type 2 diabetes. RESEARCH DESIGN AND METHODS-This was a double-blind, randomized, active-controlled, parallel-group, multicenter study of 24-week treatment with vildagliptin (100 mg daily, given as equally divided doses; It = 519) or rosiglitazone (8 mg daily, given as a once-daily dose; n = 267). RESULTS-Monotherapy with vildagliptin and rosightazone decreased A1C (baseline = 8.7%) to a similar extent during the 24-week treatment, with most of the A1C reduction achieved by weeks 12 and 16, respectively. At end point, vildagliptin was as effective as rosiglitazone, improving A1C by -1.1 +/- 0.1% (P < 0.001) and -1.3 +/- 0.1% (P < 0.001), respectively, meeting the statistical criterion for noninferiority (upper-limit 95% Cl for between-treatment difference <= 0.4%). Fasting plasma glucose decreased more with rosiglitazone (-2.3 mmol/l) than with vildagliptin (- 1.3 mmol/l). Body weight did not change in vildagliptin-treated patients(-0.3 +/- 0.2 kg) but increased in rosightazone-treated patients (+1.6 +/- 0.3 kg, P < 0.001 vs. vildagliptin). Relative to rosiglitazone, vildagliptin significantly decreased triglycendes, tot cholesterol, and LDL, non-HDL, and total-to-HDL cholesterol (-9 to -16%, all P <= 0.01) but produced a smaller increase in HDL cholesterol (+4 vs. +9%, P = 0.003). The proportion of patients experiencing an adverse event was 61.4 vs. 64.0% in patients receiving vildagliptin and rosightazone, respectively. Only one mild hypoglycemic episode was experienced by one patient in each treatment group, while the incidence of edema was greater with rosightazone (4.1%) than vildagliptin (2.1%). CONCLUSIONS-Vildagliptin is an effective and well-tolerated treatment option in Patients with type 2 diabetes, demonstrating similar glycemic reductions as rosightazone but without weight gain.