Evidence-based and tailored medication in type 2 diabetes: a pathway learned from clinical trials

Cardiovascular Diabetology
Atsushi Tanaka, Koichi Node

Abstract

In Japan, the choice of anti-diabetic medication is officially recommended according to the patient's glycemic condition and disease phenotype, unlike most other regions where metformin is recommended as the first-line medication. There has been an increase in the number of available glucose-lowering agents, making it necessary to select these agents based on ever-improving evidence obtained from clinical trials. For the dipeptidyl peptidase-4 inhibitor class of drugs, nine drugs are currently available on the market in Japan. Although previous cardiovascular outcome trials (CVOTs) demonstrated non-inferiority for both major adverse cardiovascular events (MACEs) and safety for some drugs of the class, the design and results of the CARMELINA trial seemed to be slightly different from earlier trials in that it showed the drugs were safe and partially effective even in patients with renal impairment. Thus, recent CVOTs on newer glucose-lowering agents have mainly focused on the major impacts of individual classes and drugs on clinical outcomes behind their glucose-lowering action. The diverse features of the classes and individual drugs may have also highlighted not only the class-effects, but also the drug-effects of glucose-lowe...Continue Reading

References

Sep 3, 2013·The New England Journal of Medicine·Benjamin M SciricaUNKNOWN SAVOR-TIMI 53 Steering Committee and Investigators
Mar 18, 2015·Diabetes & Vascular Disease Research : Official Journal of the International Society of Diabetes and Vascular Disease·Nikolaus MarxHans-Juergen Woerle
Dec 17, 2015·Journal of the American College of Cardiology·Stuart J PocockTim J Collier
Nov 13, 2018·JAMA : the Journal of the American Medical Association·Julio RosenstockUNKNOWN CARMELINA Investigators

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Citations

May 16, 2021·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Atsushi Tanaka, Koichi Node

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Software Mentioned

CARMELINA
CAROLINA

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