alexa Relationship of baseline HbA1c and efficacy of current glucose-lowering therapies: a meta-analysis of randomized clinical trials.
Medicine

Medicine

Internal Medicine: Open Access

Author(s): DeFronzo RA, Stonehouse AH, Han J, Wintle ME

Abstract Share this page

Abstract AIMS: Baseline glycated haemoglobin (HbA(1c)) concentrations vary between clinical trials of glucose-lowering agents and this may affect interpretation of clinical efficacy. The objective of this study is to quantify the relationship between baseline HbA(1c) and reduction of HbA(1c) in clinical trials. METHODS: PubMed literature searches from 1991 to 2007. Randomized controlled studies with placebo-controlled or comparator arms [> or = 9 patients in the intent-to-treat (ITT) population] ranging in duration from 23 to 52 weeks, in which baseline and change in glycated haemoglobin (HbA(1c)) were reported. The relationship between baseline HbA(1c) and change in HbA(1c) was analysed by a weighted least-squared regression model accounting for ITT population and variance of HbA(1c) change. Fourteen per cent of independently abstracted studies met the selection criteria. RESULTS: Meta-analysis from 59 clinical trials (8479 patients) produced weighted R(2) of 0.35 (P < 0.0001) for the association of baseline HbA(1c) and absolute change in HbA(1c). Subanalysis of eight metformin clinical trials demonstrated a stronger association [weighted R(2) of 0.67 (P = 0.0130)]. Exclusion of metformin clinical trials from the overall meta-analysis (n = 51) yielded a weighted R(2) of 0.31 (P < 0.0001). Subanalyses of clinical trials of glucose-lowering therapies predominantly targeting fasting (n = 37) or postprandial (n = 22) blood glucose produced weighted R(2) values of 0.27 (P < 0.001) and 0.42 (P < 0.005), respectively. CONCLUSIONS: These data demonstrate a positive relationship between baseline HbA(1c) and the magnitude of HbA(1c) change across 10 categories of glucose-lowering therapies, irrespective of class or mode of action. These observations should be considered when assessing clinical efficacy of diabetes therapies derived from clinical trials. This article was published in Diabet Med and referenced in Internal Medicine: Open Access

Relevant Expert PPTs

Relevant Speaker PPTs

  • Bingsong Zheng
    Identification by deep sequencing and profiling of conserved and novel hickory microRNAs involved in the graft process
    PPT Version | PDF Version
  • Yung-Chih Kuo
    “Yung-Chih Kuo-National-Chung-Cheng-University-Republic-of-China-Targeting-delivery-of-etoposide-to-inhibit-the-growth-of-human-glioblastoma-multiforme-using-lactoferrin-and-folic-acid-grafted-poly(lactide-co-glycolide)-nanoparticles”
    PPT Version | PDF Version
  • Kazuhiro Ikegame
    Graft-versus-GVHD, a second transplantation from another donor for the rescue from refractory acute GVHD
    PPT Version | PDF Version
  • Marie Schneider
    Regenerative Potential of Outer Root Sheath Melanocytes in Tissue Grafts
    PPT Version | PDF Version
  • Etakula Nagabhushan
    Studies on the Combined Effect of Multi – Walled Carbon Nano Tubes (MWCNTs) and Maleic Anhydride grafted Polypropylene (MA – g PP) on the Mechanical and Thermal Properties of Polypropylene (PP)
    PPT Version | PDF Version

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords